类风湿关节炎患者工作能力障碍相关影响因素分析

Analysis aboutrisk factors for work disability of rheumatiod arthritis patients

目的了解本院类风湿关节炎患者工作能力障碍的现状,并分析其相关影响因素。方法采用流行病学现况调查的方法,使用现场问卷调查的方式对2015年10月份至2016年2月期间在本院风湿免疫科就诊的428例RA患者进行调查,记录患者的一般资料、临床资料及工作能力相关信息,包括患者性别、年龄、发病及诊疗情况、RA对患者工作能力的影响、患者的经济状况及诊疗相关费用的支付方式等。一般资料采用描述性分析,两组间均数的比较采用t检验,RA患者工作能力障碍影响因素的相关性分析采用χ2检验。结果共纳入428例RA患者,男女比例为1∶4,平均年龄56.13±12.95岁,女性平均年龄55.04±0.70岁,男性平均年龄60.40±1.32岁。发病时在职的患者292例,因RA导致工作能力障碍者占62.33%,其中因患病工作时间减少者占45.55%,更换工作者占3.77%,病退者占13.01%。对影响RA患者工作能力的相关因素进行分析,结果显示居住地医疗条件差、收入低、从事体力劳动、HAQ评分高、发病年龄小等与工作能力障碍的发生相关。结论RA严重影响患者的工作能力,居住在农村、收入低、从事体力劳动、HAQ评分高、发病年龄小、受累关节多的患者更容易出现工作能力障碍。

Objective To study the effect of rheumatiod arthritis(RA)on work disability of patientsand analyze the factors that contribute to work disability.Methods Data of 428 patients with RA,who were admitted atdepartment of Rheumatology in our hospital,were collected.Social conditions,clinicalconditions,working conditions,financial conditions of all patients were recordedincluding the gender,age,onset and diagnosis and treatment,the impact of RA on the working ability,the economic status of patients and payment method,etc.Demographic data was shown by descriptive analysis.Student’s t-test was used for categorical data analysis.Chi-square and was used to assess the RA related indexes associated with work disability.Results Total 428 completed data were collected.The ratio of male to female was 1∶4.The onset age of female patients was(44±14)years old which was younger than that of male patients(53±13)years old.The ratio of patients who changed work because of RA was 62.33%(13.01%patients were retired before the average age,45.55%patients had to cut down the load of work,and 3.77%patients had to change job).Data analysis showed that physical laborand high HAQ score affected heavily on work abilityof patients.The multivariate logistic regression analysis showed that poor medical conditions,low income,physical labor,high HAQ score and young age of onset were related to the occurrence of work disability.Conclusions RA seriously affects the working ability of patients.Patients who live in rural areas,have low income,engage in physical labor,have high HAQ score,have younger onset age,and have more involved joints,are more likely to have work ability disorder.