活动性类风湿关节炎患者生活质量及影响因素分析

Quality o f life assessment and related factors of patients with active rheumatoid arthritis

目的探讨活动性类风湿关节炎（RA）患者的健康相关生活质量及其影响因素。方法采用健康测量量表SF-36对127例活动性RA患者的生活质量进行评价，与非活动性RA患者及健康对照者进行比较，并探讨晨僵时间、疼痛目视模拟测试表（VAS）评分、疲乏VAS评分、患者对自身健康状况的总体评价（PGA）、医生总体评价、压痛关节数（TJC）、压痛关节指数（TJI）、肿胀关节数（SJC）、肿胀关节指数（SJI）、疾病活动指数28（DAS28）、健康评估问卷（HAQ）等临床评价指标与生活质量的相关性。结果活动性RA患者SF-36量表各维度评分均明显低于健康对照者（P〈0．01）；与非活动性RA患者相比，除总体健康（GH）外，活动性RA患者其他各维度评分均明显低于非活动性RA患者（P〈0．01）。疲乏VAS评分、PGA、医生总体评价、HAQ、DAS28是与SF-36量表各维度相关最为密切的临床参数，这些临床参数与各个维度的评分均相关（r=-0．189-—0．673）。疼痛VAS评分与除情感职能（RE）外的各维度评分呈低-中度相关（r=-0．201--0．547）；TJI与除GH、RE外的各维度相关（r=-0．189--～0．466），TJC与除GH、社会功能（SF）、RE外的各维度相关（r=-0．179-—0．416），红细胞沉降率与3个维度相关（r=-0．180-—0．266）。结论活动性RA患者的生活质量明显下降，疾病活动、功能状态与患者的生活质量密切相关。

Objective To analyze the quality of life of patients with active rheumatoid arthritis （RA） and its relationship with other clinical and functional parameters used for the evaluation of disease activity. Methods The quality of life was assessed in 127 patients with active RA using SF-36 and was compared with non-active RA and the general population. The correlation between the quality of life and the clinical measures of disease, including morning stiffness, pain, fatigue, patient＇s global assessment （PGA） physician＇s global assessment , SJC/SJI, TJC/TJI, DAS28, HAQ were measured. Results The patients with active RA reported significantly decreased scores in all dimensions of SF-36. Fatigue, PGA, physician＇s global assessment, DAS28 and HAQ significantly correlated with the scores in all dimensions of SF-36. Pain was correlated with the scores in all dimensions of SF-36 except RE. TJI was correlated with six dimensions. TJC was correlated with five dimensions. ESR was correlated with three dimensions. Conclusion The quality of life in patients with active RA is significantly declined compared with non-active RA and the general population. Disease activity and functional status of patients with active RA is closely correlated with the quality of life.