I E van der Horst-Bruinsma, I Speyer, H Visser, F C Breedveld, J M Hazes
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引用次数: 188
摘要
目的:将233例早期关节炎患者(n = 233)与241例常规门诊患者(n = 241)进行比较，比较症状出现与风湿科医生就诊之间的滞后时间、临床表现和1年后诊断的一致性。结果:EAC患者的中位滞后时间减少了至少3个月。在常规临床中，发现类风湿性关节炎(RA)患者更常出现潜伏性症状。在所有病例中，70%的病例在2周后就能确诊，如果临床诊断为RA，这在接下来的一年中几乎没有改变。25%的RA患者出现早期糜坏，并与类风湿因子阳性相关(OR 2.08, 95% CI 0.95 4.59)。结论:EAC早期诊断RA是可能且可靠的;糜烂的高频率说明需要早期治疗。
Diagnosis and course of early-onset arthritis: results of a special early arthritis clinic compared to routine patient care.
Objective: Early arthritis patients referred to an Early Arthritis Clinic (EAC) (n = 233) were compared to 241 patients from the routine out-patient clinic with respect to lag time between the onset of symptoms and the visit to the rheumatologist, clinical presentation and the consistency of the diagnosis after 1 yr.
Results: The reduction in median lag time for the EAC patients was at least 3 months. An insidious onset of symptoms was found more often in the rheumatoid arthritis (RA) patients in the routine clinic. In 70% of all cases, a diagnosis could be made after 2 weeks and, if the clinical diagnosis was definite RA, this hardly changed during the following year. Early erosions were seen in 25% of RA patients and were associated with a positive rheumatoid factor (OR 2.08, 95% CI 0.95 4.59).
Conclusion: An early diagnosis of RA at the EAC is possible and reliable; the high frequency of erosions illustrates the need for early treatment.
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