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比较抗中性粒细胞胞浆抗体血管炎与类风湿关节炎患者的健康相关生活质量:一项横断面比较研究。

Health-related quality of life in patients with ANCA vasculitides compared to rheumatoid arthritis: a cross-sectional comparative study.

机构信息

Joint Rheumatology Program, Clinical Immunology-Rheumatology Unit, 2nd Department of Medicine and Laboratory, National and Kapodistrian University of Athens School of Medicine, General Hospital of Athens Hippokration, Athens, Greece.

Joint Rheumatology Program, Clinical Immunology-Rheumatology Unit, 4th Department of Medicine, National and Kapodistrian University of Athens School of Medicine, Attikon General Hospital, Athens, Greece.

出版信息

Rheumatology (Oxford). 2024 Feb 1;63(2):399-406. doi: 10.1093/rheumatology/kead214.

Abstract

OBJECTIVES

There are limited data regarding health-related quality of life (HRQoL) in patients with ANCA-associated vasculitides (AAVs). We aimed to evaluate the HRQoL in patients with AAVs and compare it to another chronic inflammatory disease like RA and to healthy controls (HC).

METHODS

This was a multicentre, cross-sectional study of patients with AAVs and RA recruited from three tertiary rheumatology clinics. HRQoL was assessed with the Short Form 36 Health Survey, which included the physical and mental component summary scores (PCS and MCS). Data from 1007 HC served as historical controls.

RESULTS

Sixty-six patients with AAVs and 71 with RA were included. Both AAV and RA patients had significantly lower PCS and MCS scores compared with HC (P < 0.05). HRQoL in AAV patients was worse in patients with microscopic polyangiitis compared with granulomatosis with polyangiitis (physical components) and those with high (VDI ≥ 3) vs low (VDI < 3) damage scores while it did not differ between those with active (BVASv3 ≥ 1) vs. inactive (BVASv3 < 1) disease. In contrast, in RA patients, HRQoL correlated both with disease activity (assessed by the DAS28-ESR) and functional impairment/damage (assessed by the HAQ). Although overall patients with RA had similar HRQoL compared with those with AAVs, those with active RA had worse HRQoL compared with those with active AAV.

CONCLUSIONS

In patients with AAVs, HRQoL correlated more with organ damage and less with disease activity whereas in RA patients, it correlated with both. These data emphasize the need for AAV therapies aiming at preventing organ damage and thus improving HRQoL.

摘要

目的

关于抗中性粒细胞胞浆抗体(ANCA)相关性血管炎(AAV)患者的健康相关生活质量(HRQoL),数据有限。我们旨在评估 AAV 患者的 HRQoL,并将其与另一种慢性炎症性疾病如类风湿关节炎(RA)和健康对照(HC)进行比较。

方法

这是一项来自三个三级风湿病诊所的 AAV 和 RA 患者的多中心、横断面研究。使用健康调查简表 36 项(SF-36)评估 HRQoL,包括生理和心理成分综合评分(PCS 和 MCS)。1007 名 HC 的数据作为历史对照。

结果

纳入了 66 名 AAV 患者和 71 名 RA 患者。AAV 和 RA 患者的 PCS 和 MCS 评分均明显低于 HC(P<0.05)。与肉芽肿性多血管炎相比,显微镜下多血管炎患者的 AAV 患者的 HRQoL 在生理成分方面较差,与高(VDI≥3)与低(VDI<3)损伤评分的患者相比,与活动(BVASv3≥1)与不活动(BVASv3<1)疾病的患者相比,HRQoL 无差异。相比之下,在 RA 患者中,HRQoL 与疾病活动度(通过 DAS28-ESR 评估)和功能障碍/损伤(通过 HAQ 评估)均相关。尽管总体而言,RA 患者的 HRQoL 与 AAV 患者相似,但活动性 RA 患者的 HRQoL 比活动性 AAV 患者差。

结论

在 AAV 患者中,HRQoL 与器官损伤的相关性更高,与疾病活动度的相关性较低,而在 RA 患者中,与两者均相关。这些数据强调了 AAV 治疗的必要性,旨在预防器官损伤,从而提高 HRQoL。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ed77/10836997/7c79768fa8e7/kead214f1.jpg

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