四川汶川大地震对类风湿关节炎病情活动影响因素的分析
|
摘要
目的:本文研究5.12四川汶川大地震造成停药、居住条件恶劣、创伤后应激障碍(posttraumatic stress dis-order,PTSD)、是否并发感染、地震破坏烈度等多种因素对类风湿关节炎(RA)患者的影响。方法:对58例确诊为RA的重灾区(北川、平武、江油、安县)地震前病情稳定患者震后一月进行血沉(ESR)和C反应蛋白(CRP)测定,同时评估患者关节肿胀、关节压痛、晨僵情况,了解患者是否病情活动,分析地震造成停药、居住条件恶劣、PTSD、并发感染及地震破坏烈度等多种因素对RA的影响。采用fisher确切概率法,分析地震破坏烈度与疾病活动是否有相关性,采用SPSS12.0软件对地震可能影响RA患者病情活动的其它相关因素进行Logistic回归分析。结果:58例患者中34例RA患者出现病情活动。fisher确切概率法分析显示:上述四县患者疾病活动构成比差别无统计学意义。病情活动者中62%患者停药;85%患者居住条件恶劣;59%患者患有PTSD;35%患者并发感染。Logistic回归分析发现停药、居住条件恶劣、PTSD及并发感染与RA患者病情活动相关(P均小于0.05)。结论:本研究中涉及的四个县RA患者疾病活动构成比差异无显著性,地震造成的停药、居住条件恶劣、PTSD、并发感染可使一部分RA患者病情活动。
Objective:To investigate the influence of those factors such as intermitting medication,wretched inhabitation,posttraumatic stress disorder(PTSD),inflammation and intensity caused by earthquake on patients of rheumatoid arthritis(RA).Methods:Fifty-eight RA patients from four disaster areas who have got remission after therapy before earthquake received investigation1 month after the disaster.Count of joint swollen,count of joint tenderness,stiff time,whether intermitting medication,inhabiting in cruel condition,and suffering from PTSD or inflammation were registered,erythrocyte sediment rate(ESR)and c-reaction protein(CRP)were detected.Analyze those factors' influence on RA patients with Logistic way.Analyze seismal intensity and the ratio of RA activity in those four areas with Fisher way.Results:Thirty-four patients relapsed after the earthquake,in which 62%internitted medication,85% inhabited in cruel condition,59% suffered from PSTD and 35% suffered from inflammation.Logistic analysis shows that intermitting medication,wretched inhabitation,PTSD and inflammation are related to RA relapse.Fisher analysis indicates that the ratio of RA activity is no significant different in those four areas.Conclusion:Part of RA patients would relapse after earthquake due to intermitting medication,wretched inhabitation,PTSD and inflammation.The ratio of RA activity is no significant different in those four areas.
Objective:To investigate the influence of those factors such as intermitting medication,wretched inhabitation,posttraumatic stress disorder(PTSD),inflammation and intensity caused by earthquake on patients of rheumatoid arthritis(RA).Methods:Fifty-eight RA patients from four disaster areas who have got remission after therapy before earthquake received investigation1 month after the disaster.Count of joint swollen,count of joint tenderness,stiff time,whether intermitting medication,inhabiting in cruel condition,and suffering from PTSD or inflammation were registered,erythrocyte sediment rate(ESR)and c-reaction protein(CRP)were detected.Analyze those factors' influence on RA patients with Logistic way.Analyze seismal intensity and the ratio of RA activity in those four areas with Fisher way.Results:Thirty-four patients relapsed after the earthquake,in which 62%internitted medication,85% inhabited in cruel condition,59% suffered from PSTD and 35% suffered from inflammation.Logistic analysis shows that intermitting medication,wretched inhabitation,PTSD and inflammation are related to RA relapse.Fisher analysis indicates that the ratio of RA activity is no significant different in those four areas.Conclusion:Part of RA patients would relapse after earthquake due to intermitting medication,wretched inhabitation,PTSD and inflammation.The ratio of RA activity is no significant different in those four areas.
引文
[1]Grady KE,Reisine ST,Fifield J,et al.The impact of Hurricane Hu-go and the San Francisco earthquake on a sample of people withrheumatoid arthritis[J].Arthritis Care Res,1991,4(2):106-110.
[2]American Psychiatric Association:Diagnostic and Statistical Manualof Mental Disorders,4th ed(DSM-IV)[M].Washington,DC,APA,1994.
[3]Drane D,Berry G.,BieriD,et al.Association between externalweather conditions and pain and stiffness in women with rheumatoidarthritis[J].J Rheumatol,1997,24:1309-1316.
[4]Strusberg I,Mendelberg RC,Serra HA,et al.Influence of weatherconditions on rheumatic pain[J].J Rheumatol,2002,29(2):335-338.
[5]Lepore L,Agosti E,Pennesi M,et al.Long-term remission inducedby measles infection and followed by immunosuppressive therapy ina case of refractory juvenile rheumatoid arthritis[J],1988,10(2):191-193.
[6]Saulsbury FT.Remission of juvenile rheumatoid arthritis with vari-cella infection[J].J Rheumatol,1999,26(7):1606-1608.
[7]Bateman HE,Kirou KA,Paget SA,et al.Remission of juvenile rheu-matoid arthritis after infection with parvovirus B19[J].J Rheuma-tol,1999,26(11):2482-2484.
[8]Remission of rheumatoid arthritis after acute disseminated varicella-zoster infection[J].Clin Rheumatol,2007,26(5):779-780.
[9]Motivala SJ,Khanna D,FitzGerald J,et al.Stress activation of cellu-lar markers of inflammation in rheumatoid arthritis:protectiveeffects of tumor necrosis factorαantagonists[J].Arthritis Rheum,2008,58(2):376-383.
[10]Stojanovich L,Marisavljevich D.Stress as a trigger of autoi mmunedisease[J].Autoi mmun Rev,2008,7(3):209-213.
[11]Hagh-Shenas H,Goodarzi MA,Farajpoor M,et al.Post-traumaticstress disorder among survivors of Bam earthquake 40 days afterthe event[J].East Mediterr Health J,2006,12:118-125.
[12]Montazeri A,Baradaran H,Omidvari S,et al.Psychological distressamong Bamearthquake survivors in Iran:a population-based study[J].BMC Public Health,2005,5:4.
[2]American Psychiatric Association:Diagnostic and Statistical Manualof Mental Disorders,4th ed(DSM-IV)[M].Washington,DC,APA,1994.
[3]Drane D,Berry G.,BieriD,et al.Association between externalweather conditions and pain and stiffness in women with rheumatoidarthritis[J].J Rheumatol,1997,24:1309-1316.
[4]Strusberg I,Mendelberg RC,Serra HA,et al.Influence of weatherconditions on rheumatic pain[J].J Rheumatol,2002,29(2):335-338.
[5]Lepore L,Agosti E,Pennesi M,et al.Long-term remission inducedby measles infection and followed by immunosuppressive therapy ina case of refractory juvenile rheumatoid arthritis[J],1988,10(2):191-193.
[6]Saulsbury FT.Remission of juvenile rheumatoid arthritis with vari-cella infection[J].J Rheumatol,1999,26(7):1606-1608.
[7]Bateman HE,Kirou KA,Paget SA,et al.Remission of juvenile rheu-matoid arthritis after infection with parvovirus B19[J].J Rheuma-tol,1999,26(11):2482-2484.
[8]Remission of rheumatoid arthritis after acute disseminated varicella-zoster infection[J].Clin Rheumatol,2007,26(5):779-780.
[9]Motivala SJ,Khanna D,FitzGerald J,et al.Stress activation of cellu-lar markers of inflammation in rheumatoid arthritis:protectiveeffects of tumor necrosis factorαantagonists[J].Arthritis Rheum,2008,58(2):376-383.
[10]Stojanovich L,Marisavljevich D.Stress as a trigger of autoi mmunedisease[J].Autoi mmun Rev,2008,7(3):209-213.
[11]Hagh-Shenas H,Goodarzi MA,Farajpoor M,et al.Post-traumaticstress disorder among survivors of Bam earthquake 40 days afterthe event[J].East Mediterr Health J,2006,12:118-125.
[12]Montazeri A,Baradaran H,Omidvari S,et al.Psychological distressamong Bamearthquake survivors in Iran:a population-based study[J].BMC Public Health,2005,5:4.
版权所有：© 2023 中国地质图书馆 中国地质调查局地学文献中心