摘要目的 了解我国类风湿关节炎(RA)我国患者工作能力障碍的情况,并分析其影响因素.方法 采用流行病学现况调查的研究方法,调查全国21家甲等医院风湿病专科737例RA患者,记录患者一般资料和工作能力相关信息,内容包括患者性别、发病年龄、职业、RA对患者工作的影响及目前经济状况.一般资料采用描述分析,2组均数比较采用t检验,RA患者工作能力障碍的影响因素的相关性分析采用X2检验及Logistic回归分析.结果 本组737例患者中,男女比例为1∶4,女性患者发病[(44±14)岁]早于男性患者[(53±13)岁].患者因RA出现工作能力障碍占35.2％,其中病退者占8.0％,减少工作量者占24.8％,更换工作者占2.4％,RA患者工作无变化者占33.8％,患病时已退休的患者占20.8％.分析患者工作能力障碍的影响因素,体力劳动者较脑力劳动者出现工作能力障碍更为明显(X2=20.497,P＜0.01),低学历者(X215.362,P＜0.01)以及健康评定量表(HAQ)评分高的患者(X2=7.511,P=-0.004)工作能力障碍发生情况多.多因素Logistic回归分析显示低学历、发病年龄大、体力劳动和HAQ评分高为患者工作能力障碍的正相关因素.收入低的患者(X2=31.882,P＜0.01)以及自费方式支付医疗费用者(X2=6.903,P=0.006)也易出现工作能力障碍.结论 RA严重影响患者的工作能力,低学历、发病年龄大、体力劳动、HAQ评分高、收入低以及自费方式支付医疗费用者更易出现工作能力障碍.

abstractsObjective To study the effect of rheumatoid arthritis (RA) on patients' work disability and analyze the factors that contribute to work disability.Methods Data were obtained from 737 patients with RA,randomly selected from Department of Rheumatology in 21 first-class hospitals in China.Data about their social conditions,clinical conditions,working conditions,financial conditions were collected.A nonparameter test and multivariate Logistic regression analysis were performed.Demographic data was shown by descriptive analysis.Student's t-test was used for categorical data analysis.Chi-square and Logistic regression analysis were used to assess the power of RA related indexes as predictors of work disability.Results Totally 737 completed data were collected.The ratio of male to female was 1∶4.The onset age of female patients [ (44±14) years ] was younger than that of male patients [ (53±13) years ].The ratio of patients who changed work because of RA was 35.2％ (8.0％ retired before the average age,24.8％ had to cut-down the load of work,2.4％ had to change job).Only 33.8％ of the patients remained their work status.Data analysis showed that physical labor (X2=20.497,P＜0.01 ),low education level (X2=15.362,P＜0.01 ) and high HAQ score (X2=7.511,P=0.004) effected heavily on patients' work ability.The multivariate logistic regression analysis showed that low academic,elder onset age were positively correlated with patients' work ability,and low HAQ and non-manual labor were protective factors for patients' work ability.Data analysis also found that patients who were low income (X2=31.882,P＜0.01 ) or had no government reimbursement (X2=6.903,P=0.006) were more likely to have work disability.Conclusion RA have a profound effect on patients' work ability in China,especially in patients with physical labor,low education level,low income,no government reimbursement and high HAQ score.