摘要
目的运用系统评价的方法了解我国类风湿关节炎(rheumatoid arthritis,RA)的疾病负担和生存质量。方法系统检索CNKI、CBM、VIP、WanFang Data、MEDLINE/PubMed、EMbase和Science Citation Index数据库,搜集有关我国RA疾病负担和生存质量的观察性研究,检索时限为1990.1.1～2010.7.31。按照纳入与排除标准选择文献、提取资料并评价纳入研究的方法学质量后,采用广义倒方差模型对RA患病率进行合并,使用RevMan 5.0软件对SF-36生活质量评分的8个维度进行Meta分析,用加权均数差(WMD)作为其效应指标,采用敏感性分析评价研究质量对结果的影响。结果共纳入20篇文献,总整体质量为中等。结果显示:RA发病率为14.7/10万;人均伤残调整寿命年(DALY)为4.92年;不计算DALY,人均年经济负担为1 250.45元,计算DALY,为15 717.91元;患者人均门诊用药费用为8 018±17 238元;加权合并的患病率为0.42%[95%CI(0.39%,0.45%)],女性患病率高于男性(P<0.05),未见长期趋势和南北方差异(P>0.05);SF-36生活质量评分8个维度WMD均有统计学意义(P<0.05)。敏感性分析显示加权合并结果稳定可靠。结论我国RA的流行病学负担和经济负担都较重,应当引起政府和社会的关注。
Objective To get known about the disease burden and quality of life （QOL） of rheumatoid artlrxtls KA） in China by conducting a systematic review. Methods The observational studies about the disease burden and QOL of RA in China were systematically searched in the following databases： CNKI, CBM, VIP, WanFang Data, MEDLINE/Pub Med, EMbase, and Science Citation Index. The retrieval time was from January 1t, 1990 to July 31＇t, 2010. According to the inclusion and exclusion criteria, the literature was screened, the data were extracted, and the methodological quality of the included studies was assessed. The morbidity of RA was pooled by adopting generic inverse variance model, the recta- analyses on 8 dimensions of SF-36 life quality score （LQS） was conducted by suing RevMan5.0 software, the weighted mean difference （WMD） was regarded as the indicator of intervention effect, and the impact of studies＇ quality on the results was assessed by sensitivity analysis. Results A total of 20 studies with medium quality in general were included. The morbidity of RA was 14.7/100 000. The disability adjusted of life years （DALYs） per capita were 4.92. If excluding the cost resulted from DALY, the overall economic cost was RMB 1 250.45 yuan per capita per year; While considering DALY, the cost was RMB 15 717.91 yuan per capita per year. The average cost of outpatient medications was RMB 8 018±17 238 yuan per capita per year. The weighted morbidity was 0.42% （95%CI 0.39% to 0.45%）, and it was higher in female than male （P〈0.05）. There was no secular trend and difference between southern and northern （P〉0.05）, but there were statistical significances in the WMD of 8 dimensions of SF-36 LQS. Sensitivity analyses revealed that the weighted pooled results were stable. Conclusion The epidemiological and economic burden of rheumatoid arthritis are heavier in China, which needs to be concerned by both government and society.
出处
《中国循证医学杂志》
CSCD
2013年第3期300-307,共8页
Chinese Journal of Evidence-based Medicine
基金
辉瑞投资有限公司提供资助
