社会剥夺对类风湿关节炎患者疾病严重程度和预后的影响。
Effect of social deprivation on disease severity and outcome in patients with rheumatoid arthritis.
作者信息
McEntegart A, Morrison E, Capell H A, Duncan M R, Porter D, Madhok R, Thomson E A
机构信息
Centre for Rheumatic Disease, Glasgow Royal Infirmary.
出版信息
Ann Rheum Dis. 1997 Jul;56(7):410-3. doi: 10.1136/ard.56.7.410.
OBJECTIVE
Social deprivation is now recognised to have an important impact on morbidity and mortality. This study sought to ascertain the effect of deprivation, if any, on disease severity, functional disability, and outcome in rheumatoid patients in Glasgow.
METHODS
814 patients with rheumatoid arthritis (RA) were assessed for clinical, functional, and laboratory indices of disease activity. Deprivation categories for individual patients were determined using the Carstairs index. Five year follow up is available for 440 patients.
RESULTS
The study population of RA patients live largely in the most deprived areas. Patients from deprived areas have significantly poorer function at outset and at five years as defined by the Health Assessment Questionnaire (HAQ) score. This is not attributable to differences in disease duration in patients from the most deprived regions or compliance with treatment. Furthermore, these patients do not achieve over five years the initial functional level of those living in the most advantaged localities.
CONCLUSION
RA patients from deprived areas have poorer function, which is associated with greater need--medical, social, and paramedical. Strategies and resources for healthcare need to be adjusted according to this variation.
目的
社会剥夺现已被认为对发病率和死亡率有重要影响。本研究旨在确定剥夺（若有）对格拉斯哥类风湿患者疾病严重程度、功能残疾及预后的影响。
方法
对814例类风湿关节炎（RA）患者的疾病活动临床、功能和实验室指标进行评估。使用卡斯尔斯指数确定个体患者的剥夺类别。440例患者有五年随访数据。
结果
RA患者研究人群大多生活在最贫困地区。根据健康评估问卷（HAQ）评分，来自贫困地区的患者在初始及五年时功能明显更差。这并非归因于最贫困地区患者的病程差异或治疗依从性。此外，这些患者在五年内未达到生活在最优越地区患者的初始功能水平。
结论
来自贫困地区的RA患者功能较差，这与更大的医疗、社会和辅助医疗需求相关。医疗保健的策略和资源需要根据这种差异进行调整。
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