类风湿关节炎达标治疗相关影响因素的临床研究

目的 调查类风湿关节炎患者（rheumatoid arthritis，RA）达标治疗情况，分析其影响因素，进一步提高RA达标治疗率。方法 选择300例RA患者，详细记录所有患者临床资料，并根据28关节疾病活动性（disease activity score in 28 joints，DAS28）评分分为达标组和未达标组。结果 RA患者中，达标率为36.7%；达标组和未达标组比较：达标组比未达标组患者平均年龄轻、文化程度高、关节肿胀数/关节压痛数少、疼痛程度评分/患者总体评估/医师总体评估（physician global assessment,PGA）低；达标组持续使用致病情缓解抗风湿病药（disease-modifying anti-rheumatic drugs,DMARDs）单药或联合治疗时间≥3个月所占比例高于未达标组；达标患者类风湿因子、红细胞沉降率、C反应蛋白、关节功能分级、生活质量得分低于未达标患者；Logistic回归分析显示：关节功能分级、C反应蛋白、PGA是RA达标治疗独立影响因素。结论 RA患者达标治疗率仍较低，DMARDs正规治疗对达标治疗具有重要作用，关节功能、C反应蛋白、PGA为RA达标治疗独立影响因素。

Treat-to-target of rheumatoid arthritis and potential determinants

Objective To investigate treat-to-target rate of rheumatoid arthritis (RA), analyse its potential determinants and to improve treat-to-target rate of RA. Methods 300 RA patients were recruited and clinical data were recorded detailedly. All 300 RA patients were devided into treat-to-target and not treat-to-target according to the disease activity score in 28 joints (DAS28). Results The treat-to-target rates of this study were 36.7%;RA patients who were treated-to-target had younger age, higher education, fewer swollen joint counts,fewer tender joint counts, lower visual analogue scale, lower patient global assessment, lower physician global assessment (PGA), lower rheumatoid factor, lower erythrocyte sedimentation rate, lower C-reactive protein level, lower joint function classification, lower health assessment questionnaire score and more regular treatment with disease-modifying anti-rheumatic drugs (≥3 months) when compared with those were not. Logistic regression analysis revealed that low PGA, low joint function classification and low C-reactive protein were independent determinants of treat-to-target. Conclusions The treat-to-target rate of RA patients was still low. Regular treatment with DMARDs was important to treat-to-target in RA. Low PGA, low C-reactive protein and low joint function classification were significant independent determinants for RA treat-to-target.