原发性痛风患者治疗依从性及达标率调查研究

Treatment compliance and uric acid control rate in patients with primary gout

目的探讨原发性痛风患者治疗依从性及达标率情况，为临床诊治工作提供参考依据。方法采用简单随机抽样法抽取2015年6月-2016年6月北京朝阳医院门诊就诊的痛风间歇期患者100例，均已接受过降尿酸治疗的，病程〉6个月，自愿加入本调查研究。采用改良的中文版风湿病治疗依从性问卷（CCQR）调查分析其治疗依从性及降尿酸治疗达标率。结果共收回有效问卷共84份。84例痛风患者中治疗依从性高者46例（54．8％），治疗依从性差者38例（45．2％）。治疗依从性高组CCQR为（73．48±15．62）分，治疗依从性低组CCQR为（48．37±10．96）分，差异有统计学意义（t=8．352，P〈0．001）。治疗依从性高组与依从性低组在文化程度、个人月收入、家族史、有无医疗保险和降尿酸药物类型方面差异无统计学意义（P〉0．05）。治疗依从性高组患者痛风病程明显短于治疗依从性低组[（6．12±1．79）年比（13．24±4．56）年，t=9．731，P〈0．001]，差异有统计学意义。治疗依从性与病程、发作频率有关，差异有统计学意义（P〈0．05）。治疗依从性高组患者降尿酸治疗达标率为35例（76．1％），明显高于治疗依从性低组14例（36．8％），差异有统计学意义（χ2=13．186，P=0．0003）。两组血尿酸平均水平分别为（369．82±35．67）μmol／L比（497．46±63．49）μmol／L，差异有统计学意义（t=11．606，P〈0．001）。结论临床上需加强痛风患者健康教育，尤其反复发作、病程较长患者对疾病认知情况的管理，提高其治疗依从性，从而提高降尿酸治疗达标率。

Objective To investigate the treatment compliance and uric acid control rate in patients with primary gout. Methods One hundred primary gout patients with disease duration 〉 6 months treated in our hospital from June 2015 to June 2016 were enrolled in the study. The treatment compliance and disease control rate were evaluated with revised Chinese Compliance Questionnaire-Rheumatology （CCQR）. Results Eighty four valid questionnaires was recovered for analysis. Among 84 patients there were 46 cases of high compliance （54. 8% ） and 38 cases of poor compliance （45. 2% ）. The CCQR score in high compliance group was significantly higher than that in poor compliance group （73.48 ± 15.62 vs. 48.37 ±10.96, t =8. 352 ,P 〈0. 001 ）. There were no significant differences in education level, personal income, family history, health insurance and type of uric-acid-lowering drugs between high compliance group and low compliance group （ P 〉 0.05 ）. The duration of gout was shorter in high compliance group than that in low compliance group [ （6.12±1.79）y vs. （13.24±4.56） y, P 〈 0. 001 ]. The uric acid control rate in high compliance group was higher than that in poor compliance group （76.1% vs. 36.8% , χ2 = 13. 186,P = 0.0013 3 ） ; and the serum uric acid levels were（ 369.82 ±35.67 ） μ mol/L and （497.46 ± 63.49 ） μ moL/L in two groups, respectively （ t = 11. 606, P 〈 0. 001 ）. Conclusion It is necessary to strengthen health education for gout patients to improve the treatment compliance and to achieve the high uric acid control rate.