全国多中心694例类风湿关节炎患者现状调查

Investigation of current situation of 694 Patients with Rheumatoid Arthritis in China

目的了解目前我国类风湿关节炎（RA）患者的诊治现状。方法本研究是从2007年3月15日至7月30日在全国16家大型综合性三甲医院进行的多中心调查。调查对象为符合美国风湿病学会1987年RA分类标准的694例患者。其中男性114例（16．43％），女性580例（83．57％），男女比例约为1：5。年龄11～85岁，平均（50±13）岁（681例），病程0～41年，平均（6±7）年。南患者本人完成“患者自评表”，专业统计人员应用SPSS13．0软件对有效调查表进行统计学处理。结果694例患者中133例（19．16％）存在系统损害，2个系统以上同时累及者为44例。红细胞沉降率（ESR）平均44mm／1h，C反应蛋白（CRP）平均21mg／L，患者视觉模拟评分法（VAS）评分中位数为69分。在治疗方而，持续应用缓解病情药物（DMARDs）3个月以上者占49．28％，非甾体抗炎药（NSAIDs）（22．86％）、糖皮质激素（11．63％）和植物制剂（9．84％）是被调查患者的主要选择用药，生物制剂用量仅占1．16％。药物疗效是患者治疗中最关注的问题（83．53％），药物不良反应是患者较为关注的问题及中断治疗的主要原因。结论目前我国RA患者中重度较多，部分存在系统损害。在治疗方面，DMARDs、NSAIDs、类同醇激素和植物制剂依然是主要选择用药，患者最关注药物疗效和不良反应问题。

Objective To investigate the current status of patients with rheumatoid arthritis in China. Methods Multi-center and cross-sectional investigation was made from March 15, 2007 to June 30,2007 in 16 centers in China, and 694 patients （114 men, 580 women, mean ±SD age 50±13 years, mean ±SD course 6±7 years） with rheumatoid arthritis were investigated who were diagnosed based on the classification criteria for rheumatoid arthritis published by American College of Rheumatology in 1987. Results In the total of 694 cases, 133 had systemic damages and 44 of them suffered with more than two systems damages. In all the 694 cases, the mean level of ESR and CRP was 44mm/h and 2.1mg/dl respectively. In addition, the mean number of VAS was 69. For the majority of patients, the therapy option was combined medications, wherein DMARDs （49.28%）, NSAIDs （22.86%）, steroid hormones （11.63%） and herbs （9.84%） were, the major options, while biological agents were used only in a minority of patients （1.16%）. Efficacy and side effects were still the most relevant factors for therapy. Conclusion There are many patients with moderate to severe rheumatoid arthritis. Some of them have systemic damage. The DMARDs, NSAIDs, steroid hormones and herbs are still the major therapeutie agents. Efficacy and side effects are the core factors that affects the choice of therapeutic regiomens.