Sany J, Dropsy R, Daurès J P
Immunorheumatology Department, Lapeyronie Hospital, Montpellier, France.
Rev Rhum Engl Ed. 1998 Jul-Sep;65(7-9):462-70.
To conduct an epidemiological study of rheumatoid arthritis patients seen by office-based rheumatologists in France (first semester of 1996).
Cross-sectional study of 1629 rheumatoid arthritis patients conducted by 373 office-based rheumatologists who volunteered for the study (one visit per patient). Each rheumatologist was to complete a 200-variable questionnaire for the first four rheumatoid arthritis patients who came to their office.
Women contributed 81% of the sample (mean age, 57 years); 19% of patients were seen in the Paris area, 20% in the North East, 20% in the North West, 22% in the South East and 19% in the South West. Twenty-nine per cent of patients had a paid job and 21.1% (all women) were homemakers. Among the patients with a paid job, 44% were on sick leave, with the reason for the sick leave being the rheumatoid arthritis in 36% of cases. Nineteen per cent of patients had stopped working permanently because of their rheumatoid arthritis, after a mean disease duration of six years. Mean disease duration in the overall sample was eight years. The diagnosis was established within six months of symptom onset in 75% of cases. A family history of rheumatoid arthritis was found in 11% of patients and a family history of other autoimmune diseases in 2%. The disease was precipitated by a stressful life event in 17% of cases. Follow-up was being provided only by the study rheumatologist in 59% of cases and also by a general practitioner in 39%. The disease was quiescent in 9% of cases, minimally active in 32%, moderately active in 46% and severely active in 13%. Eighty-four per cent of patients were on one (78%) or more (6%) second-line drugs including methotrexate (45%), an antimalarial (17%), intramuscular gold (14%), tiopronin (9%), D-penicillamine (6%) and sulfasalazine (12%). Fifty-two per cent of patients were on steroid therapy (mean dose, 7.5 +/- 5.7 mg/d). Other drugs included nonsteroidal antiinflammatory agents (61%), analgesics (61%), gastroduodenal protective agents (45%) and anxiety-relieving agents (10%). Twenty-four per cent of patients had had one or more surgical procedures (mean, 3/patient) for their joint disease.
This nation-wide epidemiological survey conducted in France provides a database on the socioeconomic and demographic characteristics of rheumatoid arthritis patients followed in private practice.
对法国门诊风湿病医生诊治的类风湿关节炎患者进行一项流行病学研究（1996年上半年）。
373名自愿参与研究的门诊风湿病医生对1629例类风湿关节炎患者进行横断面研究（每位患者就诊一次）。每位风湿病医生要为前来其诊所的前四位类风湿关节炎患者填写一份包含200个变量的问卷。
样本中女性占81%（平均年龄57岁）；19%的患者来自巴黎地区，20%来自东北部，20%来自西北部，22%来自东南部，19%来自西南部。29%的患者有带薪工作，21.1%（均为女性）是家庭主妇。在有带薪工作的患者中，44%休病假，其中36%的病假原因是类风湿关节炎。19%的患者因类风湿关节炎永久停止工作，平均病程为6年。总体样本的平均病程为8年。75%的病例在症状出现后6个月内确诊。11%的患者有类风湿关节炎家族史，2%有其他自身免疫性疾病家族史。17%的病例疾病由生活应激事件诱发。59%的病例仅由参与研究的风湿病医生进行随访，39%的病例同时还有全科医生进行随访。9%的病例疾病处于静止期，32%为轻度活动，46%为中度活动，13%为重度活动。84%的患者正在使用一种（78%）或多种（6%）二线药物，包括甲氨蝶呤（45%）、抗疟药（17%）、肌肉注射金制剂（14%）、硫普罗宁（9%）、青霉胺（6%）和柳氮磺胺吡啶（12%）。52%的患者接受类固醇治疗（平均剂量7.5±5.7毫克/天）。其他药物包括非甾体抗炎药（61%）、镇痛药（61%）、胃十二指肠保护剂（45%）和抗焦虑药（10%）。24%的患者因关节疾病接受过一次或多次外科手术（平均每位患者3次）。
在法国进行的这项全国性流行病学调查提供了一个关于私人诊所中类风湿关节炎患者社会经济和人口统计学特征的数据库。
