类风湿关节炎患者发病形式和临床特点的现况调查

Evaluation of characteristics of rheumatoid arthritis and its related factors

目的:了解类风湿关节炎(RA)患者发病形式、临床特点及对患者社会生活的影响。方法:采用流行病学现况调查的方法,对北京大学人民医院2007年5月～8月门诊就诊的RA患者进行随机现场调查。内容包括患者性别、发病年龄、关节表现、关节外表现、疾病对患者工作及生活的影响。结果:本组181例患者中,男女比例为1∶4.2,女性患者发病年龄41.8±13.4岁,早于男性的51.9±13.8岁。首发关节及病程中受累关节依次为近端指间、腕、掌指、膝、踝、跖趾及肘关节。晨僵时间持续>1h者占43.6%。患者的平均病程为9.5±8.5年,出现关节畸形94例(51.9%)。常见的关节外表现包括发热(30.3%)、类风湿结节(20.4%),并发症有继发干燥综合征(48.5%)、肺间质病变(30.3%)等。有家族史者占14.4%。因本病导致停止工作者占30.6%,病史长、关节畸形及未能在风湿免疫专科诊治为其危险因素。结论:本组RA患者多起病于中青年,患者的女性比例较高,晨僵时间较短,关节外表现常见,畸形的发生率较高,家族性发病者并不少见。患病后近1/3患者停止工作,未及时在风湿免疫专科诊治为其独立危险因素。

Objective：To describe clinical characteristic of rheumatoid arthritis （RA）and its related factors of living disability.Methods：Out patients diagnosed with RA were investigated in the hospital from May to August 2007 ,including sex, age of onset, articular and extra -articular manifestations and disease outcomes.Resuits：In these 181 RA patients,the ratio of male to female was 1：4.2.Onset age of female was younger than male.The affected joints were usually proximal interphalangeal,wrist,metaearpophalangeal etc.Up to 44% patients had morning stiffness time more than 1 hour.The mean history was 9.5±8.5 years.Deformity was observed in 94 （51.9%）patients.Common extra-articular manifestations were fever,rheumatoid nodules,secondary Sjogren＇s syndrome etc.Proportion of work disability was 30.6% and fatigue was observed in 69.4% patients. Conclusion：In this cohort of RA patients,the sex ratio,onset age and clinical characteristics were different from Caucasian patients.