C反应蛋白水平与有薪工作的强直性脊柱炎患者工作能力损失的相关性研究初探:基于脊柱关节炎智能移动管理系统的真实世界数据  

C-reactive protein is associated with impaired working capacity in Chinese patients with ankylosing spondylitis in paid employment:the real-world evidence from Smart-phone SpondyloArthritis Management System

作　　者：冀肖健 王一雯[1] 胡立冬 王雷[1] 刘兴康 宋川 张家鑫 朱剑[1] 张江林[1] 黄烽[1] Ji Xiaojian;Wang Yiwen;Hu Lidong;Wang Lei;Liu Xingkang;Song Chuan;Zhang Jiaxin;Zhu Jian;Zhang Jianglin;Huang Feng(Department of Rheumatology and Immunology,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心风湿免疫科,北京100853

出　　处：《中华内科杂志》2022年第1期99-103,共5页Chinese Journal of Internal Medicine

基　　金：十二五国家科技支撑计划项目(2014BAI07B05);国家重点基础研究发展计划(973计划)(2014CB541806)。

摘　　要：利用真实世界数据探究C反应蛋白(CRP)与强直性脊柱炎(AS)患者工作能力损失的相关性。采用脊柱关节炎智能管理系统(SpAMS)连续收录2016年4月至2018年4月解放军总医院第一医学中心确诊为AS的患者,评估CRP与工作效率及活动障碍调查问卷(WPAI)中因病缺勤时间比、疾病相关工作效率损失比、总工作生产力损失比和疾病对日常活动影响比的相关性。共纳入551例有薪工作的AS患者,患者既往7 d因病缺勤时间比为(11.0±25.1)%,疾病相关工作效率损失比为(23.9±20.3)%,总工作生产力损失比为(30.9±27.5)%,疾病对日常活动影响比为(25.6±21.9)%。与CRP≤3.17 mg/L者比,CRP>3.17~≤11.30 mg/L者、CRP>11.30 mg/L者病程更长,强直性脊柱炎病情活动度评分(ASDAS)、Bath强直性脊柱炎疾病活动度评分(BASDAI)、Bath强直性脊柱炎功能指数(BASFI)、Bath强直性脊柱炎计量指数(BASMI)更高,疾病相关工作效率损失比、总工作生产力损失比和疾病对日常活动影响比更大,接受肿瘤坏死因子α(TNFα)抑制剂和传统中药治疗者更多。多因素分析显示,基线CRP每升高10 mg/L,疾病相关工作效率损失比升高1.4%(1.1%~1.8%),总工作生产力损失比升高1.1%(0.5%~1.6%),疾病对日常活动影响比升高1.7%(1.3%~2.1%)(P值均<0.05)。工作的AS患者,基线CRP水平越高,疾病对患者既往7 d工作效率、总生产力和日常活动的影响越大,提示治疗随访中监测CRP水平非常重要,抗炎治疗可能对提高AS患者工作能力有益。To investigate the relationship between serum C-reactive protein(CRP)levels and work impairment in patients with ankylosing spondylitis(AS)based on real-world evidence.Outpatients with confirmed AS at Chinese PLA General Hospital were recruited consecutively by Smart-phone SpondyloArthritis Management System(SpAMS)from April 2016 to April 2018.The relationship between CRP and work productivity and activity impairment questionnaire(WPAI)were evaluated.Five hundred and fifty-one outpatients with AS in paid employment were recruited.The presenteeism,overall work impairment,and activity impairment rates increased by 1.4%(1.1%,1.8%),1.1%(0.5%,1.6%),and 1.7%(1.3%,2.1%),respectively,for every 10 mg/L increase in the CRP level(all P value<0.01).However,the CRP level was not associated with absenteeism after adjusting for covariates[0.5%(-0.4%,1.0%),P>0.05].There is a significant association between increased serum CRP levels at baseline and the previous 7-day work impairment in patients with AS.Higher CRP levels contribute to worse presenteeism,overall work impairment,and activity impairment rates,which suggests the necessity of monitoring CRP on treatment,and also indicates that anti-inflammatory therapy may be effective for improving work productivity.

关 键 词：脊柱炎 强直性 C反应蛋白质 工作效率损失 移动医疗 

分 类 号：R593.23[医药卫生—内科学]