强直性脊柱炎患者的工作能力及相关因素分析  

An investigation of work disability and related factors in ankylosing spondylitis patients

作　　者：杜君[1] 文琼芳 孙卓[1] 冀肖健 杨金水[1] 孙飞[1] 张江林[1] 黄烽[1] 朱剑[1] 

机构地区：[1]中国人民解放军总医院风湿科,北京100853

出　　处：《中华风湿病学杂志》2017年第8期529-535,共7页Chinese Journal of Rheumatology

基　　金：基金项目：“十二五”国家科技支撑计划（2014BA107805）;国家重点基础研究发展计划（973计划）（2014CB541806）

摘　　要：目的调查AS患者的工作能力障碍情况并分析其相关因素。方法记录2014年11月至2016年1月就诊于中国人民解放军总医院风湿科门诊的277例As患者的人口学、工作及疾病相关信息，采用中文版工作效率及活动障碍调查问卷（WPAI）调查患者工作能力障碍及工作生产力损失情况，分析其影响因素并探讨WPAI与其他患者自我评估量表的相关性。采用Logistic多元逐步回归分析患者工作能力障碍危险因素，多元线性回归分析工作生产力损失的预测因素。结果277例AS患者中工作能力障碍者84例（30．3％），其中20例因工作能力受限失业。从事工作者共200例，过去1周平均工作时长为36．5（24．0，50．0）h，AS相关因病缺勤时间为4．4（O，10）h，平均工作效率损失比为26．4％（2．5％，40．O％）。Logistic多元回归分析显示：BASDAI、SF-36量表生理健康部分得分（PCS）是各临床指标中影响患者工作能力的重要因素（OR值分别为1．270，0．959）。健康相关工作效率低下带来的工作生产力损失及总工作生产力损失均与患者整体评估、BASDAI、BASFI、SF一36量表中的生理功能（PF）、躯体疼痛（BP）、PCS呈中度相关（1rI=0．539～0．648）。多元线性逐步回归分析显示BASDAI是AS相关在职工作生产力损失和因病缺勤的重要影响因素（P〈0．01）。结论AS患者工作能力障碍发生率较高，与疾病活动度和躯体功能密切相关；AS患者工作能力障碍问题需引起重视。Objective To study the characteristics of work disability and its influencing factors in patients with ankylosing spondylitis （AS）. Methods The demographic data, work conditons and disease related characteristics of 277 patients with AS were recorded, and randomly selected from the Department of Rheumatology, Chinese PLA General Hospital from November 2014 to January 2016. Work and productivity activity impair-ment questionnaire （WPAI） Was used to survey the work disability and productivity loss, then explore its in-tluencing factors and the relationships between patient-reported outcomes and WPAI scores. Logistic regression was used to analyze the associated factors of work disability. Multivariate hnear regression was used to analyze the predictive factors of lose of work productivity. Results The prevalence of work disability was 30.3%. Twenty patients were unemployed because of working disability. Two hudreds patients were employed, with average 36.5 （24.0, 50.0） hours workingtime in the past week. Average AS related absenteeism was 4.4 （0, 10） hour. Average workproductivity loss was 26.4%（2.5%, 40.0%）. Logistic multiple regression analysis showed that Bath AS disease activity index （BASDAI）, SF-36 physical component summary （PCS） scores might be the important influencing factors among those clinical measures （OR =1.270, 0.959）. Presenteeism and overall work impairment were moderately correlated with patients＂ global assessment of disease activity （VAS）, BASDAI, bath AS functional index （BASFI）, SF-36 physical Functioning （PF）, SF-36 body pain （BP） and SF-36 Physical Component Summary （PCS） （I r 1=0.539-0.648）. Linear multivariate analyses indicated that work presente-eismand absenteeismwere significantly associated with BASDAI （P〈0.01）. Conclusion High prevalence of work disability in patients with AS is noted, which is closely related with disease activity and body function; High attention should be paid to AS patients with work disability.

关 键 词：脊柱炎 强直性 工作能力评定 工作效率及活动障碍调查问卷 

分 类 号：R593.23[医药卫生—内科学]