Quality of Life and Disability in Patients with Treatment-Failure Gout
Quality of Life and Disability in Patients with Treatment-Failure Gout
复制标题
DOI：
10.3899/jrheum.071229
复制
发表时间：
2009-05-01
影响因子：
3.9
通讯作者：
Sundy, John S.
中科院分区：
文献类型：
--
作者：
Becker, Michael A.;Schumacher, H. Ralph;Sundy, John S.
Objective.在一项为期52周的前瞻性观察性研究中，对110例治疗失败的痛风患者自我报告的生活质量与残疾和疾病严重程度之间的关系进行了评估。受试者患有至少持续2年的症状性晶体证实的痛风，并且对常规降尿酸治疗不耐受或无效。血清尿酸（sUA）浓度、肿胀和压痛关节计数、痛风发作的频率和严重程度、痛风石评估、合并症和患者报告的结局数据[医学结局研究简表-36（SF-36），健康评估量表-损伤指数。]被收集了。分析包括患者报告的结局与临床变量和临床状态变化的相关性。研究受试者的平均年龄为59岁。SF-36身体功能分量表的平均评分为34.2-46.8，与一般人群中年龄≥ 75岁的人群相似。与轻中度痛风患者相比，基线时较重度痛风患者在所有领域的健康相关生活质量（HRQOL）均较差（所有指标均为p < 0.02）。过去一年报告的耀斑数量、关节压痛、关节肿胀和痛风石数量与部分或全部HRQOL和残疾指标显著相关。sUA与任何HRQOL或残疾指标均无显著相关性。合并症的受试者经历了更差的身体，但不是精神，功能。重度痛风与HRQOL差和残疾相关，特别是对于经历更多痛风发作和有更多受累关节的患者。受试者对痛风相关功能和疼痛严重程度的感知似乎是HRQOL和残疾的高度敏感指标。（首次发布于2009年4月1日，J Rheumol 2009;36：1041-8 doi：10.3899/jrheum.071229）
Objective. The relationship between self-reported quality of life and disability and disease severity was evaluated in subjects with treatment-failure gout (n = 110) in a prospective, 52-week, observational study.Methods. Subjects had symplomatic crystal-proven gout of at least 2 years' duration and intolerance or refractoriness to conventional Urate-lowering therapy. Serum uric acid (sUA) concentration, swollen and tender joint Counts, frequency and severity of gout flares, tophus assessments, comorbidities, and patient-reported outcomes data [Medical Outcomes Study Short Form-36 (SF-36), Health Assessment Questionnaire-Damage Index.] were collected. Analyses included correlations of patient-reported Outcomes With clinical variables and changes in clinical status.Results. Mean age of study subjects was 59 years. Mean scores on SF-36 physical functioning sub-scales were 34.2-46.8, analogous to Persons aged >= 75 years in the general Population. Subjects with more severe gout at baseline had worse health-related quality of life (HRQOL) in all areas (p < 0.02 for all measures), compared to patients with mild-moderate disease. Number of flares reported in past year, number of tender joints, swollen joints, and tophi correlated significantly with some or all HRQOL and disability measures. sUA wits not significantly correlated with any HRQOL or disability measure. Subjects with comorbidities experienced worse physical, but not mental, functioning.Conclusion. Severe gout is associated with poor HRQOL and disability, especially for patients who experience more gout flares and have a greater number of involved joints. Subject perceptions of gout-related functioning and pain severity appear to be highly sensitive indicators of HRQOL and disability. (First Releaase April 1 2009 J Rheumatol 2009;36:1041-8 doi: 10.3899/jrheum.071229)