Porter D R, McInnes I, Hunter J, Capell H A
Centre for Rheumatic Diseases, Glasgow Royal Infirmary, United Kingdom.
Ann Rheum Dis. 1994 Dec;53(12):812-5. doi: 10.1136/ard.53.12.812.
To study the functional outcome in patients with rheumatoid arthritis (RA) who tolerate second line drug therapy for five years.
We enrolled into prospective controlled trials, 190 patients with rheumatoid arthritis who tolerated 'disease modifying' antirheumatic drug therapy for five years. Demographic data were recorded. Disease activity was measured every six months for two years and annually thereafter, using clinical and laboratory variables. Patient function was measured using the modified Health Assessment Questionnaire. The change in each variable was analysed using paired Wilcoxon tests.
Patient function improved significantly compared with baseline. The improvement was maximal after one to two years, and thereafter function started to decline slowly. After five years of treatment the patients' function was still significantly better than before treatment had started. There were highly significant improvements in all variables measured to assess disease activity, which remained well controlled throughout the five year period.
Good control of disease activity and improved function can be achieved long term in approximately 30% of RA patients treated with injectable gold, sulphasalazine or penicillamine.
研究耐受二线药物治疗五年的类风湿关节炎（RA）患者的功能转归。
我们将190例耐受“改善病情的”抗风湿药物治疗五年的类风湿关节炎患者纳入前瞻性对照试验。记录人口统计学数据。使用临床和实验室指标，在两年内每六个月测量一次疾病活动度，此后每年测量一次。使用改良健康评估问卷测量患者功能。使用配对Wilcoxon检验分析每个变量的变化。
与基线相比，患者功能有显著改善。改善在一至两年后达到最大，此后功能开始缓慢下降。治疗五年后，患者功能仍显著优于治疗开始前。在评估疾病活动度的所有测量变量中都有高度显著的改善，并且在整个五年期间疾病活动度一直得到良好控制。
在大约30%接受注射用金、柳氮磺胺吡啶或青霉胺治疗的RA患者中，可以长期实现疾病活动度的良好控制和功能改善。
