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类风湿关节炎患者生活质量与疾病活动度的横断面研究

[Cross-sectional study on quality of life and disease activity of rheumatoid arthritis patients].

作者信息

Zhang J F, Jin Y J, Wei H, Yao Z Q, Zhao J X

机构信息

Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2022 Dec 18;54(6):1086-1093. doi: 10.19723/j.issn.1671-167X.2022.06.005.

Abstract

OBJECTIVE

To analyze health related quality of life (HR-QoL) and physical function of outpatient department patients with rheumatoid arthritis (RA), and to analyze disease activity influence in HR-QoL and functional capacity as well as the divergences between different disease activity standards.

METHODS

The demographic and clinical data of 207 RA cases from Department of Rheumatology and Immunology, Peking University Third Hospital from Jan 2021 to Jul 2021 were collected. RA-specific quality of life (RA-QoL) and the medical outcome 36-item short form health survey (SF-36)were collected to estimate the quality of life. The test was used for the quantitative data in accordance with normal distribution.

RESULTS

A total of 207 cases were included, with RA-QoL score of 7.8±7.1, physical component summary (PCS) score of 63.8±23.8, and mental component summary (MCS) score of 71.7±21.0. According to disease activity score 28-erythrocyte sedimentation rate (DAS28-ESR), there were 119 patients (59.5%) with remission and low disease activity, and 125 patients (62.5%) with simplified disease activity index (SDAI). The HR-QoL of the patients with remission or low disease activity was significantly better than that of the patients with moderate or high disease activity. The physical function (76.7±17.2 86.4±15.0, =2.855, < 0.01), bodily pain (67.8±8.5 77.7±15.6, =4.277, < 0.01) and health transition (52.8±22.3 63.9±24.1, =2.134, < 0.05) in the low disease activity (LDA) group were lower than those in the complete remission (REM) group according to DAS28-ESR. Other domains of SF-36 and RA-QoL had no differences between these two groups. PCS in the LDA group was lower than that in the REM group (68.3±15.2 77.3±15.2, =2.716, < 0.01), but MCS was not different between the two groups. Determined by SDAI, the RA-QoL score in the LDA group was significantly higher than that in the REM group (9.4±7.1 6.0±4.8, =-2.260, < 0.05), the various dimensions of physical function in the SF-36 score and the PCS score (69.9±16.4 81.4±15.1, =3.879, < 0.05) were lower than that in the REM group, and the MCS score was lower than that in the REM group (67.9±19.3 74.5±18.8, =2.721, < 0.01).

CONCLUSION

The RA-QoL and SF-36 scores of RA patients in outpatient clinics were better, and the MCS was higher than the PCS. Treat-to-target is essential to improve HR-QoL. SDAI can better indicate the HR-QoL of each domain in REM and LDA RA patients.

摘要

目的

分析类风湿关节炎(RA)门诊患者的健康相关生活质量(HR-QoL)和身体功能,并分析疾病活动度对HR-QoL和功能能力的影响以及不同疾病活动度标准之间的差异。

方法

收集北京大学第三医院风湿免疫科2021年1月至2021年7月207例RA患者的人口统计学和临床资料。收集RA特异性生活质量(RA-QoL)和医学结局简明健康调查问卷(SF-36)以评估生活质量。符合正态分布的定量数据采用 检验。

结果

共纳入207例患者,RA-QoL评分为7.8±7.1,身体成分汇总(PCS)评分为63.8±23.8,心理成分汇总(MCS)评分为71.7±21.0。根据疾病活动度评分28-红细胞沉降率(DAS28-ESR),有119例患者(59.5%)处于缓解期且疾病活动度低,125例患者(62.5%)处于简化疾病活动指数(SDAI)状态。缓解期或低疾病活动度患者的HR-QoL显著优于中度或高疾病活动度患者。根据DAS28-ESR,低疾病活动度(LDA)组的身体功能(76.7±17.2 86.4±15.0, =2.855, < 0.01)、身体疼痛(67.8±8.5 77.7±15.6, =4.277, < 0.01)和健康转变(52.8±22.3 63.9±24.1, =2.134, < 0.05)低于完全缓解(REM)组。SF-36和RA-QoL的其他领域在两组之间无差异。LDA组的PCS低于REM组(68.3±15.2 77.3±15.2, =2.716, < 0.01),但两组之间的MCS无差异。根据SDAI确定,LDA组的RA-QoL评分显著高于REM组(9.4±7.1 6.0±4.8, =-2.260, < 0.05),SF-36评分中的身体功能各维度和PCS评分(69.9±16.4 81.4±15.1, =3.879, < 0.05)低于REM组,MCS评分低于REM组(67.9±19.3 74.5±18.8, =2.721, < 0.01)。

结论

门诊RA患者的RA-QoL和SF-36评分较好,MCS高于PCS。达标治疗对于改善HR-QoL至关重要。SDAI能更好地反映缓解期和低疾病活动度RA患者各领域HR-QoL。

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本文引用的文献

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Rheumatoid arthritis.类风湿关节炎。
Nat Rev Dis Primers. 2018 Feb 8;4:18001. doi: 10.1038/nrdp.2018.1.

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