多维健康评估量表在类风湿关节炎患者中的临床应用价值

Clinical value of multi-dimensional health assessment questionnaire in patients with rheumatoid arthritis

目的评估中文版多维健康评估量表（MDHAQ-C）在中国RA病情评估中的临床价值。方法2015年12月至2016年10月现场调查RA患者共412例，独立完成MDHAQ-C，计算患者数据指标常规评估值3（RAPID3），通过Spearman相关分析比较RAPID3和疾病临床指标及疾病活动指数DAS28-ESR、临床疾病活动指数（CDAI）、简化的疾病活动指数（SDAI）的相关性。结果RAPID3和ESR（r=0.399）、CRP（r=0.381）、肿胀关节数（SJC）（r=0.499）、压痛关节数（TJC）（r=0.558）中度相关（P〈0.01）；和疼痛视觉模拟评分法（VAS）（r=0.836）、患者病情自我评估VAS评分（r=0.915）及医生病情VAS评分（r=0.780）强相关（P〈0.001）；和疾病活动指数DAS28-ESR（r=0.784）、CDAI（r=0.734）、SDAI（r=0.682）强相关（P〈0.01）。结论MDHAQ-C用于RA疾病活动评估临床价值高，且操作简便，适用于临床工作。

Objective To evaluate the clinical value of Chinese Multi-Dimensional Health Assessment Questionnaire （MDHAQ-C） in patients with rheumatoid arthritis （RA）.MethodsFrom December 2015 to October 2016, four hundred and twelve RA patients were recruited in this study and completed the MDHAQ-C independently and routine assessment of patient index data 3 （RAPID3） was calculated. Then correlations were assessed by Spearman correlation coefficient of RAPID3 with indices of clinical relevance and disease activity to evaluate its clinical values.ResultsMDHAQ-C is moderately correlated with ESR （r=0.399）, CRP （r=0.381）, SJC （r=0.499）, TJC （r=0.558） （P〈0.01）, but highly correlation with VAS of pain （r=0.836）, VAS of global status （r=0.915） and overall assessment of physician （r=0.784）（P〈0.01）, and highly correlated with a Spearman＇s coefficient of 0.784 for DAS 28-ESR, 0.734 for CDAI and 0.682 for SDAI（P〈0.001）.ConclusionMDHAQ is a reliable, valid instrument for disease activity assessment and a feasible index for clinical settings in Chinese RA patients.