Blackmore M G, Gladman D D, Husted J, Long J A, Farewell V T
Psoriatic Arthritis Clinic, University of Toronto, Wellesley Hospital, Ontario, Canada.
J Rheumatol. 1995 May;22(5):886-93.
The Health Assessment Questionnaire (HAQ) has proven to be a reliable and valid measure of outcome for a variety of arthritides. A recent modification of HAQ for spondyloarthropathy (HAQ-S) has also been reported. Our purpose was to evaluate the HAQ and HAQ-S as outcome measures in the assessment of patients with psoriatic arthritis (PsA).
The HAQ, including HAQ-S was administered to all patients attending our Psoriatic Arthritis Clinic between June and December, 1993. Clinical and radiological assessments were performed according to a standard protocol that measures disease activity, fibrositic tender points (TP), disease severity and damage. Analysis was performed using SAS for the PC.
The patient population included 114 patients, 70 men and 44 women with a mean age of 49.3 years and a mean arthritis duration of 15.1 years. The mean HAQ score was 0.50, while the mean HAQ-S score was 0.53 (scores range 0 to 3 for this instrument). The overall HAQ and HAQ-S disability scores were highly correlated with several clinical measures of function, including grip strength (r = -0.63 and -0.59, respectively). American College of Rheumatology functional class (r = 0.59 and 0.60, respectively), as well as the number of fibrositic TP (r = 0.54 and 0.57, respectively). These disability scores also correlated highly with the overall number of actively inflamed joints (r = 0.49 and 0.50, respectively); however, they correlated only moderately or poorly with other measures of disease activity such as morning stiffness, total number of joint effusions, erythrocyte sedimentation rate (ESR) and the PASI score for psoriasis and with all measures of disease severity. A similar pattern of correlations was found between the individual subscales of the HAQ and HAQ-S and the clinical measures of function, activity, and severity, as well as between the pain scale and the various clinical measures. However, the correlations are generally lower.
Our data suggest that HAQ and HAQ-S capture clinical measures of function and pain in PsA but do not correlate with disease severity. The HAQ and its modification for spondyloarthropathy may reflect fibromyaglia as a measure of pain and tenderness in these patients. Thus, the clinical assessment of disease activity and both clinical and radiological assessments of joint damage remain important outcome measures in PsA.
健康评估问卷（HAQ）已被证明是衡量多种关节炎预后的可靠且有效的指标。最近也有关于针对脊柱关节炎对HAQ进行改良（HAQ-S）的报道。我们的目的是评估HAQ和HAQ-S作为银屑病关节炎（PsA）患者评估中的预后指标。
1993年6月至12月期间，对所有前往我们银屑病关节炎诊所就诊的患者进行了HAQ（包括HAQ-S）评估。根据测量疾病活动度、纤维性压痛点（TP）、疾病严重程度和损伤情况的标准方案进行临床和放射学评估。使用SAS for the PC进行分析。
患者群体包括114名患者，70名男性和44名女性，平均年龄49.3岁，平均关节炎病程15.1年。HAQ平均得分为0.50，而HAQ-S平均得分为0.53（该工具得分范围为0至3）。总体HAQ和HAQ-S残疾评分与多项功能临床指标高度相关，包括握力（分别为r = -0.63和-0.59）、美国风湿病学会功能分级（分别为r = 0.59和0.60）以及纤维性TP数量（分别为r = 0.54和0.57）。这些残疾评分也与活跃炎症关节的总数高度相关（分别为r = 0.49和0.50）；然而，它们与疾病活动的其他指标如晨僵、关节积液总数、红细胞沉降率（ESR）以及银屑病的PASI评分以及所有疾病严重程度指标仅呈中度或低度相关。HAQ和HAQ-S的各个子量表与功能、活动和严重程度的临床指标之间，以及疼痛量表与各种临床指标之间也发现了类似的相关模式。然而，相关性一般较低。
我们的数据表明，HAQ和HAQ-S能够反映PsA患者功能和疼痛的临床指标，但与疾病严重程度无关。HAQ及其针对脊柱关节炎的改良版本可能反映纤维肌痛，作为这些患者疼痛和压痛的一种衡量指标。因此，疾病活动度的临床评估以及关节损伤的临床和放射学评估在PsA中仍然是重要的预后指标。
