摘要
目的了解我国目前痛风患者对所患痛风的诊疗认知及风湿科医师对痛风的系统化诊治现状，以探讨未来对痛风患者和风湿科医师加强痛风知识教育的侧重点。方法依照痛风患者的关注点和痛风诊疗指南，分别设计痛风患者和风湿科医师问卷，进行面对面调查。124例痛风患者填写了患者问卷；11个省份的269名风湿科医师填写了医师问卷。分别对问卷结果进行统计学分析，统计学方法采用，检验。结果①收回124份患者答卷，8例患者（6．5％）认为急性痛风发作由细菌或病毒引发；7例（5．6％）认为降尿酸目标值为600μmol／L；仍有41例（33．1％）认为秋水仙碱、激素及非甾体抗炎药有降尿酸的作用；②收回252份医师答卷，156名医师（61．9％）认为急性痛风发作时血尿酸水平一定升高；25名（9．9％）认为应在首次痛风急性发作时开始降尿酸治疗；134名（53．2％）认为开始降尿酸治疗时不需要同时服用秋水仙碱预防痛风发作；③根据医师对痛风诊疗指南的认知情况将被调查医师分为2组，调查显示2组医师对急性痛风发作时血尿酸水平的高低、开始降尿酸的时间、降尿酸治疗的目标值、痛风诊断依据、开始治疗是否予秋水仙碱预防复发5个问题的答案的正确选择率差异有统计学意义[分别为56．4％（93／165）与3．4％（3／87），98．2％（162／165）与14．9％（13／87），86．1％（142／165）与6．9％（6／87），70．3％（116／165）与29．9％（26／87），32．7％（54／165）与13．8％（12／87）；矿分别为35．745，42．277，48．511，11．673，6．515，P均〈0．05]；而患者文化程度及痛风病史长短与痛风诊疗认匀知间差异无统计学意义。结论加强对患者痛风基本知识教育，有助于痛风患者提高对痛风的了解，配合医师做系统治疗；加深风湿病专业医师诊疗培训，有助于进一步加强其对痛风的认识，以求对痛风开展系统化治疗。
Objective To investigate the awareness of gout patients with the diagnosis and treatment of gout and the status of rheumatologists＇ awareness of the treatment of gout. Methods The questionnaires were developed for gout patients and rheumatologists for the survey of their awareness of gout and its treatment. One hundred and twenty-four cases of gout patients were interviewed and they completed the patients question- naires. Two hundred and sixty-nine rheumatologists in 11 provinces were interviewed and completed the doctors＇ questionnaire. And the results of questionnaires were analyzed byx2 test. Results One hundred and twenty-four questionnaires of patients were collected. Most patients understood the causes of gout and the target value of uric acid lowering treatment, but they did not realize the related questions about the treatment of gout. Eight patients（6.5%） considered that acute attacks of gout was caused by bacteria or virus; 7 patients （5.6%） thought that the target value of uric acid lowering treatment was 600 uLmol/L. Forty-one patients （33.1%） considered colchicine, steroid and NSAIDs were the uric acid lowering medications. Two hundred and fifty-two questionnaires from rheumatologists were collected. Some rheumatologists did not fully understand the consensus about gout treatment; 156 rheumatologists （61.9%） thought that serum uric acid must be higher during the acute attack stage; 25 physicians （9.9%） thought that the urate lowing drugs should be taken by patients during acute gout attack first time; 134 of them （53.2%） thought that prevention against gout flare using colchicine was not necessary during the first month of urate lowing therapy. According to the cognitionabout the guidelines for diagnosis and t^atment of gout, the surveyed physicians were divided into two groups. And there were significant difference between the two groups about the follow cpestions： the blood uric acid level during acute gnut attacks, the initiation of urate-lowering time, the target value of the urate level, the diagnosis of gout and whether to start colchicine treatment for the prevention of recurrence [56.4%（93/165） vs 3.4%（3/87）, 98.2%（162/165） vs 14.9%（13/87）, 86.1% （142/165） vs 6.9%（6/87）, 70.3% （116/165） vs 29.9%（26/87）, 32.7%（54/165 ） vs 13.8%（12/87）, respectively; X2=35.745,42.277, 48.511, 11.673, 6.515, all P〈0.05 ]; and the awareness of diagnosis were not statistically different from the treatment of gout. Conclusion The basic knowledge education should be further emphssi~.ed among patients to improve the understanding of gout and to cooperate with doctors to treat gout systematically; and the training should be evolved among rheumatologists to improve the awareness of gout in order to treat gout systematically.
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2013年第4期255-258,共4页
Chinese Journal of Rheumatology
