某三甲医院类风湿关节炎患者发病特征及生命质量调查研究

Study on Characteristics and Quality Of Life of the Patients with Rheumatoid Arthritis in a Tertiary Grade Hospital.

目的分析甘肃省某三甲医院类风湿关节炎（RA）患者发病特征及生命质量，为RA的诊治和预后评估提供临床依据。方法回顾性统计分析兰州大学第一医院风湿免疫科2011年1月至2014年1月收治的244例RA患者病历资料，并对所有入组患者进行电话随访。结果本项研究发现RA患者男女比例约为1：3；年龄分布上46～60岁最多，占44．7％（109／244）；兰州市患者比较多，占42．64％；职业分布中工人及农民的比例较高，分别为31．97％和29．92％；45％的患者手关节x线出现RA改变；早期（病程〈6月）确诊的IRA比例最高占46．31％。随访结果显示，有效随访103（42．21％）例。62例（60．19％）缓解，41例（39．81％）处于疾病活动期；影响RA患者生命质量的因素为年龄、性别、目前居住地、医疗费用支付方式、职业、首次确诊时间、一级亲属RA家族史、疾病活动程度及出院后治疗方式。结论应尽早明确诊断，加强RA患者的疾病知识教育及医患沟通，为RA患者确定合理的个体化治疗方案，使RA患者接受长期正规的抗风湿治疗及随访，才能切实改善患者的预后和生命质量。

Objective To analyze the characteristics and quality of life of patient with rheumatoid arthritis （RA） in a tertiary hospital of Gansu province. Then we can provide clinical evidence to the diagnosis and prognostic evaluation of RA. Methods To retrospective statistical analyze the record of 244 RA patients admitted in the First Hospital of Lanzhou University from January 2011 to January 2014. All the patients were followed up by phone. Results In this study we find that proportion of men and women in RA is about 1：3; The age distribution of 46 to 60 years old is 44.7% （109/244）;There are more patients in Lanzhou,42.64%.The proportion of workers and farmers in the occupational distribution is most. It is 31.97% and 29.92%. 45 percent of the patients had hand joint RA changes by X-ray films. The highest percentage of cases diagnosed in the early stage was 46.31 percent. Follow-up results show that the effective follow-up is 103 cases （42.21%）, in which 62 cases are alleviated （60.19%）, and 41 cases （39.81%）are in disease activity. The life quality of pa- tients with RA is related with age, gender, current residence, payment of medical charges, occupation, time of first con- firmed diagnosis, family history of RA diagnosis, extent of disease activity and treatment after discharged. Discussion We should confirm diagnosis early, strengthen the disease knowledge education and doctor-patient communication, to make reasonable individualized treatment plan for RA patients, to help the RA patients receive long-term regular anti-rheuma- tism treatment and follow-up, which can improve the prognosis for patients and their quality of life.