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多中心银屑病关节炎患者临床行为与治疗状况的横断面研究

[Cross-sectional study on clinic behavior and therapeutic status of patients with psoriatic arthritis in multi-center].

作者信息

Li Y H, Su B, Lin F A, Fei Y N, Yu X X, Fan W Q, Chen H Y, Zhang X W, Jia Y

机构信息

Department of Rheumatology & Immunology, Peking University People's Hospital, Beijing 100044, China.

Department of Endocrinology, General Aerospace Hospital, Beijing 100012, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2019 Dec 18;51(6):1014-1018. doi: 10.19723/j.issn.1671-167X.2019.06.006.

Abstract

OBJECTIVE

To investigate and analyse the features of treatment behavior and standardized therapeutic status of patients with psoriatic arthritis (PsA).

METHODS

Out patients diagnosed with PsA in People's Hospital of Peking University, Haidian Hospital, People's Hospital of Jianyang City, Central Hospital of Xinxiang City, Integrated Traditional Chinese and Western Medicine Hospital of Cangzhou City, The Third Hospital of Hebei Medical University from February to June 2018 were enrolled in this investigation. The data including gender, age of onset, course of disease, site of first consulting department, time of the first visit and definite diagnosis, follow-up interval, and use of conventional disease modifying anti-rheumatic drugs (cDMARDs) and biological DMARDs (BioDMARDs) were collected and analyzed.

RESULTS

In the cross-sectional study, 133 PsA patients were investigated. The mean age of onset was (47±11) years, the male to female ratio was 1.3:1, and mean disease duration was (16±8) years. Rheumatology department was the most common site of first hospital visit (37.6%, 50/133). Orthopedics department and dermatological department were visited by 24.1% (32/133) and 23.3% (31/133), respectively. Ratio of definite diagnosis was the highest in rheumatology department which was 78% (39/50). The ratio of definite diagnosis of dermatological department was the second highest, which was 19.4% (6/31). The mean definite diagnosed time was 7.6 months since the first visit of PsA patients, and diagnosed time was the shortest in rheumatology department, which had statistical significance. 37% PsA patients were treated appropriately in 3 months, 17.3% PsA patients were treated in 3-6 months and 40.2% patients with PsA visited their doctor more than once a year. 48.8% patients hadn't received standardized treatment before visit, and one third patients never received the therapy of DMARDs. Methotrexate was the most commonly used cDMARDs (58.3%), followed by leflunomide (20.5%) and BioDMARDs (19.7%), and biologicals were tumor necrosis factor antagonists.

CONCLUSION

In this multi-center study, the first visit department of PsA patients was widely distributed, and most patients were definitely diagnosed in Rheumatology Department. The time of their first visit and definite diagnosis were delayed due to multi factors. Nearly half of the patients did not receive standardized treatment.

摘要

目的

调查和分析银屑病关节炎(PsA)患者的治疗行为特征及规范化治疗现状。

方法

选取2018年2月至6月在北京大学人民医院、海淀医院、简阳市人民医院、新乡市中心医院、沧州市中西医结合医院、河北医科大学第三医院确诊为PsA的门诊患者进行调查。收集并分析患者的性别、发病年龄、病程、首诊科室、首次就诊及确诊时间、随访间隔,以及传统改善病情抗风湿药物(cDMARDs)和生物DMARDs(BioDMARDs)的使用情况。

结果

横断面研究共纳入133例PsA患者。平均发病年龄为(47±11)岁,男女比例为1.3:1,平均病程为(16±8)年。风湿免疫科是最常见的首诊科室(37.6%,50/133)。骨科和皮肤科的首诊比例分别为24.1%(32/133)和23.3%(31/133)。确诊率在风湿免疫科最高,为78%(39/50)。皮肤科的确诊率次之,为19.4%(6/31)。PsA患者自首次就诊至确诊的平均时间为7.6个月,其中在风湿免疫科确诊时间最短,差异具有统计学意义。37%的PsA患者在3个月内得到了恰当治疗,17.3%的患者在3至6个月内得到治疗,40.2%的PsA患者每年就诊次数超过1次。48.8%的患者在就诊前未接受规范化治疗,三分之一的患者从未接受过DMARDs治疗。甲氨蝶呤是最常用的cDMARDs(58.3%),其次是来氟米特(20.5%)和BioDMARDs(19.7%),生物制剂为肿瘤坏死因子拮抗剂。

结论

在这项多中心研究中,PsA患者的首诊科室分布广泛,多数患者在风湿免疫科确诊。由于多种因素,患者的首次就诊及确诊时间延迟。近半数患者未接受规范化治疗。

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