Romatoid artrit hastalarında farklı eklem tutulumlarının hastalık aktivitesi, fonksiyonellik ve yaşam kalitesi üzerindeki etkileri
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Dosyalar
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Romatoid artrit hastalık aktivitesinin belirlenmesi için gerek klinik aras?tırmalarda gerekse pratikte sıklıkla kullanılan indekslerde (disease activity score 28, clinical disease activity index, simplified disease activity index gibi) 28 belirli eklemin durumuna go?re hassas ve s?is? eklem sayısı hesaplanır ve bu 28 belirli eklemin hastalık aktivitesi u?zerindeki ag?ırlıg?ı birbirinden farklı olarak deg?erlendirilmez. Biz de bu çalıs?mamızda romatoid artrit hastalarında farklı eklem tutulumlarının hastaların yas?am kalitesini ve fonksiyonellik durumunu farklı du?zeylerde etkiledig?ini, mevcut 28 eklemli indekslerde yer almayan metatarsofalangeal ve ayak bileg?i eklemi tutulumun o?nemini go?stermeyi amaçladık. Çalıs?mamıza, Trakya U?niversitesi Tıp Faku?ltesi Hastanesi romatoloji poliklig?ine Haziran 2020-Haziran 2021 tarihleri arasında bas?vuran, 2010 American College of Rheumatology/ European League Against Rheumatism kriterlerine go?re romatoid artrit tanısı konulan hastalar içerisinden, aktif artriti olan 100 hasta alınmıs?tır. Çalıs?maya alınan hastaların hassas/s?is? eklemleri belirlenmis?, disease activity score 28, simplified disease activity index, clinical disease activity index hesaplanmıs?tır. Hastaların fonksiyonel durumunun belirlenmesi amacıyla health assesment questionnaire-disability index, yas?am kalitesi belirlenmesi amacıyla quality of life-rheumatoid arthritis testi yapılmıs?tır. Health assesment questionnaire-disability index skorunu en çok etkileyen eklemlerin sırasıyla omuz, metatarsofalangeal ve proksimal interfalangeal eklemler oldug?u go?ru?ldu?. Dig?er eklemlerin yapılan regresyon modelinde health assesment questionnaire-disability index u?zerinde bag?ımsız prediktif etkisinin olmadıg?ı go?ru?ldu?. Quality of life-rheumatoid arthritis indeksini en çok etkileyen sırasıyla omuz, metatarsofalangeal ve dirsek oldug?u go?ru?ldu?. El bileg?i ve ayak bileg?i dıs?ındaki tu?m eklemler quality of life-rheumatoid arthritis u?zerinde bag?ımsız prediktif etkin oldug?u go?ru?ldu?. Ayak bileg?i tutulumu olan ve olmayan hastaların health assesment questionnairedisability index ve quality of life-rheumatoid arthritis indeksleri benzer olarak izlendi. Metatarsofalangeal eklem tutulumu olan hastaların tutulum olmayan hastalara go?re health assesment questionnaire-disability index ve quality of life-rheumatoid arthritis skorları daha yu?ksek izlendi. Hem ayak bileg?i hem de metatarsofalangeal eklem tutulumunun hastalık aktivite indekslerinden bag?ımsız olarak hastaların fonksiyonellik ve yas?am kalitesini etkileyemedig?i go?ru?ldu?. Çalıs?mamızda romatoid artrit hastalarında farklı eklem tutulumlarının hastaların fonksiyonellig?ini ve yas?am kalitesini farklı du?zeylerde etkiledig?i go?sterildi. Metatarsofalangeal ve ayak bileg?i tutulumlarının hastaların fonksiyonellik ve yas?am kalitesi u?zerinde hastalık aktivite indekslerinden bag?ımsız olarak etkili olmadıg?ı go?ru?lmekle birlikte bu konuda daha fazla çalıs?maya ihtiyaç duyuldug?u du?s?u?nu?lmektedir.
In order to determine rheumatoid arthritis disease activity, the number of tender and swollen joints is calculated according to the condition of 28 certain joints in indexes (such as disease activity score 28, clinical disease activity index, simplified disease activity index) that are frequently used both in clinical studies and in practice, and the weight of these 28 specific joints on disease activity is not evaluated differently from each other. In this study, we aimed to show that different joint involvements in rheumatoid arthritis patients affect the quality of life and functionality of patients at different levels, and the importance of metatarsophalangeal and ankle joint involvement, which are not included in the current 28-joint indices. 100 patients with active arthritis were included in our study among the patients who applied to the rheumatology outpatient clinic of Trakya University Medical Faculty Hospital between June 2020 and June 2021 and were diagnosed with rheumatoid arthritis according to the 2010 American College of Rheumatology/ European League Against Rheumatism criteria. Tender/swelling joints of the patients included in the study were determined, and disease activity score 28, simplified disease activity index, clinical disease activity indexwere calculated. Health assesment questionnaire-disability indexwas used to determine the functional status of the patients, and the quality of life-rheumatoid arthritistest was used to determine the quality of life. It was observed that the joints that most affected the health assesment questionnairedisability index were the shoulder, metatarsophalangeal and proximal interphalangeal joints, respectively. It was observed that there was no independent predictive effect on health assesment questionnaire-disability indexin the regression model of other joints. It was observed that the most affectingquality of life-rheumatoid arthritisindex were shoulder, metatarsophalangeal and elbow, respectively. All joints except wrist and ankle were found to have an independent predictive effect on quality of life-rheumatoid arthritis. Health assesment questionnaire-disability indexand quality of life-rheumatoid arthritisindices of patients with and without ankle involvement were similar. Patients with metatarsophalangeal joint involvement had higher health assesment questionnaire-disability indexand quality of life-rheumatoid arthritisscores than patients without involvement. It was observed that both the ankle and metatarsophalangeal joint could not affect the functionality and quality of life of the patients, regardless of disease activity indices. In our study, it was shown that different joint involvements in rheumatoid arthritis patients affected the functionality and quality of life of patients at different levels. Although it is seen that metatarsophalangeal and ankle involvements do not have an effect on the functionality and quality of life of patients independently of disease activity indices, it is thought that more studies are needed on this subject.
In order to determine rheumatoid arthritis disease activity, the number of tender and swollen joints is calculated according to the condition of 28 certain joints in indexes (such as disease activity score 28, clinical disease activity index, simplified disease activity index) that are frequently used both in clinical studies and in practice, and the weight of these 28 specific joints on disease activity is not evaluated differently from each other. In this study, we aimed to show that different joint involvements in rheumatoid arthritis patients affect the quality of life and functionality of patients at different levels, and the importance of metatarsophalangeal and ankle joint involvement, which are not included in the current 28-joint indices. 100 patients with active arthritis were included in our study among the patients who applied to the rheumatology outpatient clinic of Trakya University Medical Faculty Hospital between June 2020 and June 2021 and were diagnosed with rheumatoid arthritis according to the 2010 American College of Rheumatology/ European League Against Rheumatism criteria. Tender/swelling joints of the patients included in the study were determined, and disease activity score 28, simplified disease activity index, clinical disease activity indexwere calculated. Health assesment questionnaire-disability indexwas used to determine the functional status of the patients, and the quality of life-rheumatoid arthritistest was used to determine the quality of life. It was observed that the joints that most affected the health assesment questionnairedisability index were the shoulder, metatarsophalangeal and proximal interphalangeal joints, respectively. It was observed that there was no independent predictive effect on health assesment questionnaire-disability indexin the regression model of other joints. It was observed that the most affectingquality of life-rheumatoid arthritisindex were shoulder, metatarsophalangeal and elbow, respectively. All joints except wrist and ankle were found to have an independent predictive effect on quality of life-rheumatoid arthritis. Health assesment questionnaire-disability indexand quality of life-rheumatoid arthritisindices of patients with and without ankle involvement were similar. Patients with metatarsophalangeal joint involvement had higher health assesment questionnaire-disability indexand quality of life-rheumatoid arthritisscores than patients without involvement. It was observed that both the ankle and metatarsophalangeal joint could not affect the functionality and quality of life of the patients, regardless of disease activity indices. In our study, it was shown that different joint involvements in rheumatoid arthritis patients affected the functionality and quality of life of patients at different levels. Although it is seen that metatarsophalangeal and ankle involvements do not have an effect on the functionality and quality of life of patients independently of disease activity indices, it is thought that more studies are needed on this subject.
Açıklama
Anahtar Kelimeler
Romatoid artrit, Metatarsofalangeal eklem, Ayak bileği, Rheumatoid arthritis, Metatarsophalangeal joint, Ankle
