Gabriel S E
Division of Rheumatology, Mayo Clinic, Rochester, MN 55905, USA.
Curr Opin Rheumatol. 1996 Mar;8(2):96-100. doi: 10.1097/00002281-199603000-00002.
Epidemiologic studies continue to enhance our understanding of the rheumatic diseases. Such studies now indicate that 26 million American women are at risk for osteoporotic fractures. Contrary to previous recommendations, the identification and treatment of patients at risk for osteoporosis may be valuable even among very elderly people. Other epidemiologic studies suggest that the incidence of rheumatoid arthritis is decreasing and that it is a more benign disease than previously recognized. Osteoarthritis remains a leading cause of physical and work disability in North America. The roles of occupational physical activity, obesity, and highly competitive (though not low-impact) exercise as risk factors for osteoarthritis continue to be explored. Pharmacoepidemiologic research has recently demonstrated that a policy of prior authorization for prescription of nonsteroidal anti-inflammatory drugs may be highly cost effective. Finally, controlled epidemiologic studies have not confirmed an association between silicone breast implants and connective tissue diseases, a conclusion recently endorsed by the American College of Rheumatology.
流行病学研究不断增进我们对风湿性疾病的了解。此类研究目前表明，2600万美国女性面临骨质疏松性骨折的风险。与先前的建议相反，即使在非常年长的人群中，识别和治疗有骨质疏松风险的患者可能也很有价值。其他流行病学研究表明，类风湿关节炎的发病率正在下降，且它是一种比之前认为的更为良性的疾病。骨关节炎仍然是北美身体和工作残疾的主要原因。职业体力活动、肥胖以及高强度竞技（而非低强度）运动作为骨关节炎风险因素的作用仍在不断探索中。药物流行病学研究最近表明，非甾体抗炎药处方事先授权政策可能具有很高的成本效益。最后，对照流行病学研究尚未证实硅胶乳房植入物与结缔组织疾病之间存在关联，这一结论最近得到了美国风湿病学会的认可。
