类风湿关节炎患者的疼痛状况调查及相关因素分析

Pain and related factors in patients with rheumatoid arthritis

关键词:  类风湿关节炎  疼痛  视觉模拟评分

Key words:  rheumatoid arthritis  pain  visual analog scale

摘要:

目的 调查类风湿关节炎（RA）患者的疼痛状况并分析相关因素。方法 共收集了625例类风湿关节炎（rheumatoid arthritis，RA）患者，视觉模拟评分（VAS）评估患者疼痛程度，以VAS平均值分为两组（VAS<43.8组与VAS≥43.8组），分析疼痛的相关危险因素。再选取关节压痛和肿胀均为阴性的患者共143例，分为VAS<20组和VAS≥20两组，分析疼痛的相关危险因素。结果 625例RA患者中VAS≥20者比例高达70%，疼痛危险因素包括男性、晨僵时间、肿胀关节数、压痛关节数、PLT、ESR、NSAIDs应用率。在关节压痛和肿胀均为阴性的患者中仍有23%的患者VAS超过20，但未得出疼痛的相关危险因素。结论 疼痛是RA患者严重的临床症状，疾病活动度不是唯一导致疼痛的因素。

Abstract:

Objective To investigate pain prevalence in patients with rheumatoid arthritis (RA), and to analyze pain-related risk factors. Methods Totally, 625 patients with RA were recruited. Visual analog scale (VAS) was applied for pain assessment. Patients were divided into two groups according to the average VAS score of 43.8, and independent predictors of pain were analyzed. The 143 patients without joint swelling or joint pain were further divided into two groups according to VAS score of 20, and independent predictors of pain were analyzed. Results Among the 625 RA patients, the proportion of patients with VAS≥20 was as high as 70%. Independent predictors of pain included male, morning stiffness time, swollen joint count, tender joint count, ESR, PLT and the usage rate of NSAIDs. Among the 143 RA patients without joint swelling or joint pain, the proportion of patients with VAS≥20 was 23%. However, no risk factors were detected. Conclusion Pain is a serious clinical symptom in RA patients. Disease activity is not the only risk factor of pain.