Gladman D D, Shuckett R, Russell M L, Thorne J C, Schachter R K
University of Toronto Rheumatic Disease Unit, Women's College Hospital, Ontario, Canada.
Q J Med. 1987 Feb;62(238):127-41.
Since 1978, 220 patients with psoriatic arthritis have undergone detailed study at the Women's College Hospital in Toronto, Canada. Clinical, radiological and biochemical data were subjected to computer analysis in order to determine clinical-biochemical correlations within subsets of patients with psoriatic arthritis. Our findings indicate a spectrum of disease patterns and severity. Overall, we found a 40 per cent incidence of deforming, erosive arthropathy, with 17 per cent of patients having five or more deformed joints. ARA stage 3 and 4 radiological joint change occurred in 28 and 14 per cent respectively, and 11 per cent of patients had ARA Class III or IV functional impairment. The asymmetric oligoarthritis previously reported to account for the majority of cases of psoriatic arthritis was not a dominant pattern in our own experience, occurring in only 28 per cent of the series. Polyarthritis was the most common joint pattern, present in 61 per cent with symmetric and asymmetric patterns occurring equally. Our experience suggests that polyarthritis, symmetric or asymmetric, is a more common presentation of the disease than is generally acknowledged. Furthermore, the frequency of deforming destructive arthropathy challenges the concept of psoriatic arthritis as a benign arthropathy.
自1978年以来，220例银屑病关节炎患者在加拿大多伦多女子学院医院接受了详细研究。对临床、放射学和生化数据进行了计算机分析，以确定银屑病关节炎患者亚组内的临床-生化相关性。我们的研究结果表明了一系列疾病模式和严重程度。总体而言，我们发现畸形、侵蚀性关节病的发生率为40%，17%的患者有五个或更多畸形关节。分别有28%和14%的患者出现美国风湿病学会（ARA）3期和4期放射学关节改变，11%的患者有ARA III级或IV级功能障碍。先前报道占银屑病关节炎大多数病例的不对称少关节炎在我们的经验中并非主要模式，仅在该系列的28%中出现。多关节炎是最常见的关节模式，占61%，对称和不对称模式出现的频率相同。我们的经验表明，多关节炎，无论对称与否，是该疾病比普遍认为更为常见的表现形式。此外，畸形破坏性关节病的频率对银屑病关节炎是一种良性关节病的概念提出了挑战。
