Clinical burden of erosive hand osteoarthritis and its relationship to nodes
Clinical burden of erosive hand osteoarthritis and its relationship to nodes
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DOI：
10.1136/ard.2009.125435
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发表时间：
2010-10-01
影响因子：
27.4
通讯作者：
Kloppenburg, M.
中科院分区：
文献类型：
--
作者：
Bijsterbosch, J.;Watt, I.;Kloppenburg, M.
目的探讨手部糜烂性骨关节炎（EOA）患者的疼痛、功能和健康相关生活质量（HRQL）的临床负担及其与结节性骨关节炎（OA）的关系。采用澳大利亚/加拿大骨关节炎手部指数（AUSCAN）、密歇根手部结局问卷（MHQ）和压力时的疼痛强度评估疼痛。通过AUSCAN、MHQ、握力、捏握和手移动测试评估功能。使用简表-36测量HRQL。同时评价了患者对手部功能和美观的满意度。评估了淋巴结OA的存在及其程度（通过淋巴结数量反映）。采用线性混合模型估计患者组间的平均差异。要确定是否差异是独立的结节性质的疾病，调整了nodes.Results患者经历了更多的疼痛，更多的功能限制，不满意的手功能和美学和更差的手比非EOA患者的流动性。两组的HRQL相似。EOA患者的淋巴结较多。淋巴结数量越多，预后越差。校正后的节点的数量，只有手的灵活性和病人的满意度仍然不同groups.Conclusion患者EOA有较高的临床负担比那些非糜烂性疾病。这种较高的负担只是部分归因于糜烂性疾病本身，但主要是由于疾病的结节性特征。
Objective To describe the clinical burden of erosive osteoarthritis (EOA) of the hand in terms of pain, functioning and health-related quality of life (HRQL) and its relationship to nodal osteoarthritis (OA).Methods Patients with EOA (n=42) and non-EOA (n=194) of the hand were compared. Pain was assessed with the Australian/Canadian Osteoarthritis Hand Index (AUSCAN), the Michigan Hand Outcome Questionnaire (MHQ) and pain intensity upon pressure. Functioning was evaluated with AUSCAN, MHQ, grip strength, pinch grip and hand mobility tests. HRQL was measured with the Short Form-36. Patient satisfaction with hand function and aesthetics were also evaluated. The presence of nodal OA as well as its extent (reflected by the number of nodes) was assessed. Mean differences between patient groups were estimated with linear mixed models. To determine whether differences were independent of the nodal character of the disease, adjustments were made for the number of nodes.Results Patients with EOA experienced more pain, more functional limitation, less satisfaction with hand function and aesthetics and worse hand mobility than patients with non-EOA. HRQL was similar for the two groups. Patients with EOA had more nodes. A higher number of nodes was associated with worse outcome. After correction for the number of nodes, only hand mobility and patient satisfaction remained different between the groups.Conclusion Patients with EOA have a higher clinical burden than those with non-erosive disease. This higher burden is only partly attributed to the erosive disease itself, but mainly to the nodal character of the disease.