Halla J T, Hardin J G, Fallahi S
Department of Medicine, University of Alabama, Birmingham.
Rheumatol Int. 1987;7(4):169-71. doi: 10.1007/BF00270365.
A total of 300 consecutive patients referred to a tertiary-care center and fulfilling the American Rheumatism Association criteria for definite-classical rheumatoid arthritis, (with a mean disease-duration of 10.3 +/- 9 years) were studied by structured interview and medical record review. The type of onset (rapid or insidious), type of joint involved (small, medium, large or combined joints) and pattern of joint involvement (monarticular, pauciarticular or polyarticular) at onset, and the interval between the first symptom and development of established disease were determined from the interview (based on the patient's memory). The onset was rapid in 46%. Initial involvement occurred in small joints in 31%, medium joints in 16%, large joints in 28% and combined sites in 25%. The pattern of joint involvement at onset was monarticular in 21%, pauciarticular in 44% and polyarticular in 35%. The time for disease to become established was less than 1 month in 25%, 1-6 months in 35%, 6-12 months in 14% and over 1 year in 26%. The monarticular pattern of onset was associated with slower development of established disease than the other patterns of joint involvement; polyarticular disease tended to be associated with polyarticular onset; involvement of large joints was associated with pauciarticular onset.
共有300例连续转诊至三级医疗中心且符合美国风湿病协会明确的经典类风湿关节炎标准（平均病程为10.3±9年）的患者，通过结构化访谈和病历回顾进行研究。从访谈中（基于患者的记忆）确定发病类型（急骤或隐匿）、发病时受累关节类型（小关节、中关节、大关节或联合关节）和关节受累模式（单关节、少关节或多关节），以及首发症状与确诊疾病发展之间的间隔时间。46%的患者发病急骤。初始受累发生在小关节的占31%，中关节的占16%，大关节的占28%，联合部位的占25%。发病时关节受累模式为单关节的占21%，少关节的占44%，多关节的占35%。疾病确诊时间不到1个月的占25%，1至6个月的占35%，6至12个月的占14%，超过1年的占26%。与其他关节受累模式相比，单关节发病模式与确诊疾病的发展较慢相关；多关节疾病往往与多关节发病相关；大关节受累与少关节发病相关。
