不同程度的疾病活动对类风湿关节炎患者疼痛概况和生活质量的影响

S. D. Mendes, B. L. Queiroz, L. V. Santana, A. Baptista, M. Santiago, K. Sá
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引用次数: 3

摘要

类风湿关节炎(RA)是一种全身性炎症性自身免疫性疾病,其发病率和死亡率都在不断增加。不同水平的疾病活动(LDA)已经确立,然而,其对疼痛和生活质量的影响尚未得到证实。本研究的目的是评估不同程度的疾病活动与诊断为RA的患者的疼痛状况和生活质量(QOL)的关系。这是一项横断面研究,在巴西巴伊亚州萨尔瓦多的教育门诊护理服务的RA患者中进行。根据28个关节的疾病活动评分(DAS28),根据红细胞沉降率(ESR)、视觉模拟量表(VAS)和肿胀和疼痛关节的数量来定义LDA。采用双神经痛量表(DN4)评估疼痛类型。采用健康问卷(SF-36)和健康评估问卷(HAQ)对患者的生活质量进行评价。LDA、QOL和疼痛状况之间的关系采用单因素方差分析和Bonferroni校正后验进行验证。在本研究评估的96例患者中,67.7%的患者存在高LAD。94.8%的参与者报告痛觉,其中40.6%报告痛觉是伤害性的,80.2%报告痛觉是强烈的。我们还观察到,LAD越高,报告的疼痛强度越高(p=0.001),生活质量评分越低(p<0.001)。虽然LDA与疼痛类型无关(p=0.611),但它与HAQ在生活质量中获得的总分相关(p=0.001)。通过SF-36评估对生活质量影响最大的是身体(p<0.001)和功能容量(p<0.001)。综上所述,LDA高的RA患者疼痛感更严重,生活质量评分最低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
IMPACT OF DIFFERENT LEVELS OF DISEASE ACTIVITY IN PAINFUL PROFILE AND QUALITY OF LIFE IN PEOPLE WITH RHEUMATOID ARTHRITIS
Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune disease with impact on increasing the morbidity and mortality rates. Different levels of disease activity (LDA) have been established, however, its impact on pain and quality of life have yet to be been evidenced. The aim of this study was to evaluate the relationship of different levels of disease activity on the painful profile and quality of life (QOL) of patients diagnosed with RA. This was a cross-sectional study, conducted in RA patients attending an Educational Outpatient Care Service in Salvador, Bahia, Brazil. The LDA was defined according to values of Erythrocyte Sedimentation Rate (ESR), Visual Analog Scale (VAS), and number of swollen and sore joints, according to the Disease Activity Score in 28 joints (DAS28). Types of pain were assessed using the Douleur Neuropathique en 4 questions (DN4). To evaluate QOL, the Short Form (36) Health Survey (SF-36) and Health Assessment Questionnaire (HAQ) were applied. The association between LDA, QOL and painful profile was verified using One Way-ANOVA and Bonferroni correction post-test. A high LAD was observed in 67.7% of the 96 patients  evaluated in this study. Pain sensation was reported by 94.8 % of participants with 40.6 % reporting it as nociceptive and 80.2% as intense. It was also observed that the higher LAD found the higher was the pain intensity reported (p=0.001) and lower QOL scores (p<0.001). Although the LDA did not correlate with the type of pain (p=0.611), it was correlated with the total score obtained in the QOL from the HAQ (p=0.001). The greatest impact on QOL evaluated through the SF-36 were physical (p<0.001) and functional capacity (p<0.001). In conclusion, RA patients who had high LDA reported more severe pain perception and obtained the lowest scores in the assessment of quality of life.
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