牛皮关节炎的诊断延迟:来自全国多中心研究的见解
Gamze Kılıç1, Erkan Kılıç2, İbrahim Tekeoğlu3
1Division of Rheumatology, Department of PMR, Karadeniz Technical University School of Medicine, Trabzon, Turkey. gkilic.md@hotmail.com.
Rheumatology international
|October 8, 2023
概括
牛皮关节炎 (PsA) 的延迟诊断会影响患者的治疗结果. 像低教育和关节炎前的皮肤问题等因素有助于延迟,尽管诊断时间正在改善.
科学领域:
- 类风湿病学 类风湿病学
- 流行病学 流行病学
- 临床医学 临床医学
背景情况:
- 牛皮关节炎 (PsA) 诊断可能会延迟,这可能会影响患者的管理和结果.
- 了解诊断延迟的持续时间和促成因素对于改善早期检测策略至关重要.
研究的目的:
- 为了调查牛皮关节炎 (PsA) 患者的诊断延迟的持续时间.
- 用基于人口的方法确定与延迟PsA诊断相关的人口和临床因素.
主要方法:
- 从TLAR网络分析了1,134名符合CASPAR标准的PsA患者的数据.
- 诊断延迟被定义为症状发作到PsA诊断时间;后勤回归确定了促成因素.
- 评估了时间趋势和与疾病活动,生活质量和功能相关的关联.
主要成果:
- 平均诊断延迟时间为35.1个月; 67.02%的患者在24个月内被诊断出来. 延迟的中位数从60个月 (2010年之前) 减少到24个月 (2015-2019年).
- 较长的延迟与更高的PsAQoL,FACIT-Fatigue,BASDAI,PtGA和PhGA分数相关.
- 延迟诊断的重要因素包括低学历 (OR=2.63),关节炎之前的皮肤症状 (OR=1.72),腰部疼痛 (OR=1.60).
结论:
- 尽管情况有所改善,但大约三分之一的PsA患者的诊断延迟超过两年.
- 教育水平较低,关节炎在皮肤表现之前,以及最初的症状是导致PsA诊断延迟的关键因素.
- 针对这些因素的有针对性的干预措施可以促进早期发现PsA并改善患者管理.
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