骨关节炎患者用药治疗现状的全国多中心大样本现场调查  

A multi-center cross-sectional survey of medicine application in patients with osteoarthritis in China

作　　者：张晓盈[1] 彭嘉婧 刘传慧[2] 蔡小燕[3] 张江林[4] 梅轶芳[5] 靳洪涛[6] 王晓非[7] 磨红[8] 栗占国[1] ZHANG Xiao-ying;PENG Jia-jing;LIU Chuan-hui;CAI Xiao-yan;ZHANG Jiang-lin;MEI Yi-fang;JIN Hong-tao;WANG Xiao-fei;MO Hong;LI Zhan-guo(Department of Rheumatology and Inmmnology,Peking University People＇s Hospital,Beijing 100044,China;Department of Rheumatology and Immunology,Zhengzhou Orthopaedics Hospital,Zhengzhou 450052,China;Department of Rheumatology and Inmmnology,Guangzhou First People＇s Hospital,Guangzhou 510180,China;Department of Rheumatology and Immunology,Chinese PLA General Hospital,Beijing 100039,China;Department of Rheumatology and hnmunology,The First Hospital of Harbin Medical University,Harbin 150001,China;Department of Rheumatology and hnmunology,The Second Hospital of Hebei Medical University,Shijiazhuang 050000,China;Department of Rheumatology and hnmunology,Shengjing Hospital of China Medical University,Shenyang 110004,China;Department of Rheumatology and hnmunology,Nanning First People＇s Hospital,Nanning 530022,China)

机构地区：[1]北京大学人民医院风湿免疫科,北京100044 [2]郑州市骨科医院风湿免疫科,郑州450052 [3]广州市第一人民医院风湿免疫科,广州510180 [4]中国人民解放军总医院风湿免疫科,北京100039 [5]哈尔滨医科大学附属第一医院风湿免疫科,哈尔滨150001 [6]河北医科大学第二医院风湿免疫科,石家庄050000 [7]中国医科大学附属盛京医院风湿免疫科,沈阳110004 [8]南宁市第一人民医院风湿免疫科,南宁530022

出　　处：《北京大学学报（医学版）》2018年第6期1044-1048,共5页Journal of Peking University:Health Sciences

摘　　要：目的:目的:评估骨关节炎在我国患病及用药现况,并进行疾病评估。方法:采用流行病学现场调查的研究方法,对2017年4—10月全国40家医院1 066例骨关节炎患者的一般资料、患病情况、用药情况以及关节功能进行评估。数据采用SPSS 19. 0软件进行统计学处理,采用t检验、Mann-Whitney U检验、卡方检验对数据进行分析。结果:本组1 066例患者中,男、女比例为1∶3. 6,平均年龄(61. 9±11. 0)岁,年龄分布于36~94岁。膝骨关节炎、髋骨关节炎、手骨关节炎患病人数分别是873例(81. 9%)、150例(14. 1%)、387例(36. 3%),其中合并两个部位的患者242例(22. 7%),3个部位均受累关节炎患者为51例(4. 8%)。56. 6%(603/1 066)患者应用过1种及以上非甾体抗炎药,28. 9%(308/1 066)患者应用1种及以上止痛药物。61. 2%(652/1 066)应用1种及以上改善病情骨关节炎药,包括氨基葡萄糖(400/1 066,37. 5%)、硫酸软骨素(21/1 066,2. 0%)、双醋瑞因(63/1 066,5. 9%)或联合应用2种以上改善病情骨关节炎药(168/1 066,15. 8%)。92例(8. 6%)患者应用止痛药控制症状,未进一步使用抗炎及保护关节药物。232例(21. 8%)患者应用关节腔穿刺注射药物,应用玻璃酸钠或糖皮质激素分别为98例(9. 2%)和48例(4. 5%),而将二者联合应用达86例(8. 1%)。应用局部外用药物患者占26. 5%(283/1 066),理疗占15. 8%(168/1 066)。与膝关节受累患者相比,髋关节受累患者的病情明显更加严重,两组患者按照美国西部安大略和麦克马斯特大学(the Western Ontario and McMaster Universities,WOMAC)骨关节炎指数评分评估疼痛(Z=-7. 625,P <0. 001)、僵硬感(Z=-6. 229,P <0. 001)、关节功能(Z=-6. 777,P <0. 001),差异均有统计学意义,并且髋骨关节炎患者更多应用止痛药物(χ2=24. 838,P <0. 001)。结论:我国骨关节炎患者以口服非甾体抗炎药及改善病情骨关节炎药为主要治疗方式,但存在药物使用不规范情况;与膝骨关节炎相比,髋Objective： To investigate the clinical characteristics,the medicine application and to evaluate the disease activity in patients with osteoarthritis（ OA） in China. Methods： This was a cross-sectional study. Totally 1 066 cases of OA from 40 hospitals in China from April to October 2017 were retrospectively enrolled. Demographic characteristics,clinical data,medicine application,and joint function were evaluated. All the data were analyzed by SPSS software 19. 0. t test,Mann-Whitney U test and chi-square test were used for statistical analysis. Results： In the 1 066 cases,the male-to-female ratio was 1 ∶ 3. 6 and the average age was（ 61. 9 ± 11. 0） years,with an age range from 36 to 94 years.The incidence of knee OA,hip OA,and hand OA were respectively 81. 9%（ 873/1 066）,14. 1%（ 150/1 066）,and 36. 3%（ 387/1 066）. In the study,242（ 22. 7%） cases had two kinds of joint areas involved and three joint areas were involved in 51 cases（ 4. 8%）,and 56. 6%（ 603/1 066） of the patients used more than one kind of non-steroid anti-inflammatory drugs（ NSAIDs） while 61. 2%（ 652/1 066） used disease modifying osteoarthritis drugs（ DMOADs）,including glucosamine（ 37. 5%,400/1 066）,chondroitin sulfate（ 2. 0%,21/1 066）,diacetate（ 5. 9%,63/1 066）,and the combination of these drugs（ 15. 8%,168/1 066）. 8. 6%（ 92/1 066） patients only took analgesics to relieve the pain,not using any kind of NSAIDs or DMOADs. And 232 patients（ 21. 7%） had intra-articular injections,including 9. 2%（ 98/1 066） sodium hyaluronate,4. 5%（ 48/1 066） glucocorticoid,and 8. 1%（ 86/1 066） combination of the two drugs. The proportion of the patients taking topical drugs accounted for26. 5%（ 283/1 066） and physical therapy accounted for 15. 8%（ 168/1 066）. Compared with those who suffered from knee OA,the patients who suffered from hip OA had more severe disease assessment.Moreover,there were significant differences in pain（ Z =-7. 625,P〈0. 001）,morning stiffness（

关 键 词：骨关节炎 治疗药物 现场调查 

分 类 号：R593[医药卫生—内科学]