Investigation the Influence of Sichuan Wenchuan Earthquake on Patients of Rheumatoid Arthritis_West China Medical Journal

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Department of Rheumatology and Immunology，The Center Hospital of Mianyang City，Mianyang Sichuan 621000，China;

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Keywords：

地震; 類風濕關節炎

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目的:本文研究5·12四川汶川大地震造成停藥、居住條件惡劣、創傷后應激障礙（posttraumatic stress disorder，PTSD）、是否并發感染、地震破壞烈度等多種因素對類風濕關節炎（RA）患者的影響。方法:對58例確診為RA的重災區（北川、平武、江油、安縣）地震前病情穩定患者震后一月進行血沉（ESR）和C反應蛋白（CRP）測定，同時評估患者關節腫脹、關節壓痛、晨僵情況，了解患者是否病情活動，分析地震造成停藥、居住條件惡劣、PTSD、并發感染及地震破壞烈度等多種因素對RA的影響。采用fisher確切概率法，分析地震破壞烈度與疾病活動是否有相關性，采用SPSS12.0軟件對地震可能影響RA患者病情活動的其它相關因素進行Logistic回歸分析。結果:58例患者中34例RA患者出現病情活動。fisher確切概率法分析顯示:上述四縣患者疾病活動構成比差別無統計學意義。病情活動者中62%患者停藥；85%患者居住條件惡劣；59%患者患有PTSD；35%患者并發感染。Logistic回歸分析發現停藥、居住條件惡劣、PTSD及并發感染與RA患者病情活動相關（P均小于0.05）。結論：本研究中涉及的四個縣RA患者疾病活動構成比差異無顯著性，地震造成的停藥、居住條件惡劣、PTSD、并發感染可使一部分RA患者病情活動。

Citation： YANG Jing,DONG Jianlin,ZOU Jinmei,et al.. Investigation the Influence of Sichuan Wenchuan Earthquake on Patients of Rheumatoid Arthritis. West China Medical Journal, 2009, 24(1): 120-122. doi: Copy

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1. Grady KE，Reisine ST，Fifield J，et al.The impact of Hurricane Hugo and the San Francisco earthquake on a sample of people with rheumatoid arthritis[J].Arthritis Care Res，1991，4（2）:106-110..
2. American Psychiatric Association:Diagnostic and Statistical Manual of Mental Disorders，4th ed （DSM-IV）[M].Washington，DC，APA，1994..
3. Drane D，Berry G.，BieriD，et al.Association between external weather conditions and pain and stiffness in women with rheumatoid arthritis[J].J Rheumatol，1997，24:1309-1316..
4. Strusberg I，Mendelberg RC，Serra HA，et al.Influence of weather conditions on rheumatic pain[J].J Rheumatol，2002，29（2）:335-338..
5. Lepore L，Agosti E，Pennesi M，et al.Longterm remission induced by measles infection and followed by immunosuppressive therapy in a case of refractory juvenile rheumatoid arthritis[J]，1988，10（2）:191-193..
6. Saulsbury FT.Remission of juvenile rheumatoid arthritis with varicella infection[J].J Rheumatol，1999，26（7）:1606-1608..
7. Bateman HE，Kirou KA，Paget SA，et al.Remission of juvenile rheumatoid arthritis after infection with parvovirus B19[J].J Rheumatol，1999，26（11）:2482-2484..
8. Remission of rheumatoid arthritis after acute disseminated varicellazoster infection[J].Clin Rheumatol，2007，26（5）:779-780..
9. Motivala SJ，Khanna D，FitzGerald J，et al.Stress activation of cellular markers of inflammation in rheumatoid arthritis:protective effects of tumor necrosis factor α antagonists[J].Arthritis Rheum.
10. Stojanovich L，Marisavljevich D.Stress as a trigger of autoimmune disease[J].Autoimmun Rev，2008，7（3）:209-213..
11. HaghShenas H，Goodarzi MA，Farajpoor M，et al.Posttraumatic stress disorder among survivors of Bam earthquake 40 days after the event[J].East Mediterr Health J，2006，12:118-125..
12. Montazeri A，Baradaran H，Omidvari S，et al.Psychological distress among Bam earthquake survivors in Iran:a populationbased study[J].BMC Public Health，2005，5:4..

West China Medical Journal

Investigation the Influence of Sichuan Wenchuan Earthquake on Patients of Rheumatoid Arthritis

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