Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, UK.
Best Pract Res Clin Rheumatol. 2020 Apr;34(2):101562. doi: 10.1016/j.berh.2020.101562. Epub 2020 Jul 6.
Rheumatoid arthritis (RA) is associated with pain, disability and increased risk of developing comorbidities and premature mortality. While these poor outcomes have improved in line with advances in the treatment of RA, they still persist to some degree today. Physical activity and smoking are two areas of patients' lives where changes may have a substantial impact on the poor outcomes associated with RA. Physical activity in RA has been well studied, with many randomised trials indicating the benefits of physical activity on pain and disability. A number of observational studies have assessed the impact of smoking on RA, also indicating the benefits of quitting smoking on RA-related outcomes, but with less consistent findings, potentially due to epidemiological challenges (e.g. collider bias, recall bias). There are also a number of barriers preventing patients making these positive lifestyle changes, such as lack of time and motivation, lack of knowledge and advice, as well as disease-specific barriers, such as pain and fatigue.
类风湿关节炎（RA）与疼痛、残疾以及罹患合并症和过早死亡的风险增加有关。尽管随着 RA 治疗的进步，这些不良结局有所改善，但在今天，它们仍在一定程度上存在。在患者生活的某些方面，如身体活动和吸烟，改变可能会对 RA 相关的不良结局产生重大影响。RA 中的身体活动已经得到了很好的研究，许多随机试验表明身体活动对疼痛和残疾有好处。一些观察性研究评估了吸烟对 RA 的影响，也表明戒烟对 RA 相关结局有好处，但发现结果不一致，这可能是由于存在流行病学挑战（例如，混杂偏倚、回忆偏倚）。还有许多障碍阻止患者做出这些积极的生活方式改变，例如缺乏时间和动力、缺乏知识和建议，以及疾病特异性障碍，如疼痛和疲劳。
