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基于自报问卷的韩国强直性脊柱炎患者诊断过程的真实世界体验。

Real-world experiences of the diagnosis process in Korean patients with ankylosing spondylitis based on a self-report questionnaire.

机构信息

Division of Rheumatology, Department of Internal Medicine, Nowon Eulji University Hospital, Seoul, Republic of Korea.

Division of Rheumatology, Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Republic of Korea.

出版信息

J Int Med Res. 2021 Apr;49(4):3000605211004201. doi: 10.1177/03000605211004201.

Abstract

OBJECTIVES

The diagnosis of ankylosing spondylitis (AS) is often delayed, which affects various clinical outcomes. This study examined the real-world situation of patients with AS during diagnosis and treatment.

METHODS

Data were obtained from 26 tertiary care hospitals in Korea using a self-report questionnaire. The questionnaire assessed symptoms, pain, extra-articular manifestations, the initial pattern of pain before diagnosis, factors leading to delayed referral to rheumatology, time until receiving an AS diagnosis, comorbid diseases, treatment status, and disease education needs.

RESULTS

Between September and October 2019, 1012 patients with AS completed the survey. Of these, 75.8% were men and 51.8% were in their 30s or 40s. Median disease duration was 76 months. The median time to diagnosis with AS was 12 months. When pain occurred, the medical departments most frequently visited first were orthopedic (61.5%) and rheumatology (18.7%) departments. The likelihood of the first visit being to the orthopedic department and the frequency of biologics use increased with the disease duration. The rates of uveitis, depressed mood, and comorbid diseases were higher in the group with delayed diagnosis.

CONCLUSIONS

Physicians should be aware of subtypes of AS that take longer to diagnose and comorbid diseases in the real-world clinical setting.

摘要

目的

强直性脊柱炎(AS)的诊断常常被延误,这会影响到各种临床结局。本研究考察了 AS 患者在诊断和治疗过程中的实际情况。

方法

本研究使用自填式问卷,从韩国 26 家三级护理医院获取数据。问卷评估了症状、疼痛、关节外表现、诊断前初始疼痛模式、导致向风湿病学转诊延迟的因素、获得 AS 诊断的时间、合并症、治疗状况以及疾病教育需求。

结果

2019 年 9 月至 10 月期间,1012 名 AS 患者完成了调查。其中,75.8%为男性,51.8%为 30 多岁或 40 多岁。疾病病程中位数为 76 个月。AS 的中位诊断时间为 12 个月。出现疼痛时,患者首先最常去的医疗科室是骨科(61.5%)和风湿病科(18.7%)。首次就诊于骨科科室的可能性以及生物制剂使用的频率随着疾病病程的延长而增加。延迟诊断组的虹膜炎、情绪低落和合并症的发生率更高。

结论

在真实临床环境中,医生应注意到那些诊断时间更长的 AS 亚型和合并症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/897f/8033485/e67bf727ebfd/10.1177_03000605211004201-fig1.jpg

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