UTJECAJ JUTARNJE UKOČENOSTI, OBRAZOVANJA I DOBI NA FUNKCIONALNI STATUS BOLESNIKA S REUMATOIDNIM ARTRITISOM

Vjollca Sahatçiu-Meka, Sylejman Rexhepi, Suzana Manxhuka-Kërliu, Kelmend Pallaska, Ardiana Murtezani, Teuta Osmani-Vllasolli, Mjellma Rexhepi, Blerta Rexhepi

Th e purpose of this study was to explore the relationship between disability status and duration of morning stiff ness in hands with regard to age, level of education, and gender in patients with rheumatoid arthritis (RA). Also, the authors wanted to investigate this relationship with regard to the presence of rheumatoid factor, i.e., the serological status.  A retrospective study was conducted in 250 patients with the classic form of RA (186 females, 64 males, mean age Xb = 49.96 years, range 25-60 years, disease duration 1-27 years, Xb = 6.41) previously diagnosed with RA according
to the ACR (American College of Rheumatology 1987 criteria). All patients were in Steinbrocker functional classes II and III. Th e probability level was expressed by p < 0.01 and p < 0.05. Th e relationship between the variables was measured by point-biserial correlation. The correlation between duration of morning stiff ness and functional class was positive but low [(r = 0.10, y = 0.00x + 2.37, p > 0.05) seronegative, (r = 0.12, y = 0.00x + 2.30,
p > 0.05) seropositive]. High positive values were obtained for the linear correlation coeffi cient between duration of the disease and functional class (p < 0.01). Also, high values were obtained regarding the coeffi cient of correlation between age and functional class [(r = 0.29, p < 0.01) seronegative, (r = 0.47, p < 0.01) seropositive]. Uneducated patients were signifi cantly more represented in functional class III [23 (50%) seronegative, 19 (42.2%) seropositive] than in functional class II [16 (20.3%) seronegative, 22 (27.5%) seropositive]. In conclusion, in this study of patients with rheumatoid
arthritis, increased duration of morning stiff ness was associated with functional disability. Functional disability increased with the duration of the disease, depended on age and educational level, and was more pronounced in older age, regardless of RA serological status. With regard to serological status and sex, the diff erences were non-signifi cant.

Svrha istraživanja bila je proučiti i usporediti odnos između funkcionalnog statusa i trajanja jutarnje zakočenosti u šakama s obzirom na dob, razinu obrazovanja i spol u bolesnika s reumatoidnim artritisom (RA). Istražena je povezanost tih čimbenika u odnosu na postojanje reumatoidnog faktora, odnosno serološki status. Ova retrospektivna studija provedena je u 250 bolesnika s klasičnim oblikom RA (186 žena, 64 muškarca). Ispitanici su bili u dobi između 25 i 60 godina, (x=49.96) s trajanjem bolesti od jedne do 27 godina (x =6.41) i nisu ispunjavali revidirane dijagnostičke kriterije ACR-a (American College of Rheumatology – 1987). Svi ispitanici pripadali su II. i III. funkcionalnom razredu prema Steinbrockerovoj klasifi kaciji. Odnos između funkcionalnih razreda i odabranih varijabli (trajanje jutarnje ukočenosti u rukama, spol, dob i stupanj obrazovanja) u odnosu na serostatus mjeren je point-biserijalnim koefi cijentom korelacije. Nađena je pozitivna, iako niska korelacija između trajanja jutarnje ukočenosti i funkcionalnih klasa [(r=0.10, y=0.00x 2.37, p> 0.05) seronegativni, (r=0.12, y=0.00x 2.30, p>0.05) seropozitivni]. Visoke pozitivne vrijednosti dobivene su pri određivanju koefi cijenta linearne korelacije između trajanja bolesti i funkcionalnih klasa (p<0.01). Također su visoke vrijednosti dobivene za koefi cijent korelacije između dobi i funkcionalnih klasa [(r=0.29, p<0.01) seronegativni, (r=0.47, p<0.01) seropozitivni]. Slabije obrazovani bolesnici bili su znatno više zastupljeni u III. funkcionalnom razredu [23 (50%) seronegativni, 19 (42.2%) seropozitivni] nego u II. funkcionalnom razredu [16 (20.3%) seronegativni, 22 (27.5%) seropozitivni]. Zaključno, prema ovoj studiji bolesnika s reumatoidnim artritisom dulje trajanje jutarnje zakočenosti bilo je povezano sa stupnjem funkcionalne nesposobnosti. Funkcionalna nesposobnost bila je povećana s trajanjem bolesti, ovisna o dobi i obrazovnoj razini te je izraženija u starijoj dobi, bez obzira na RA serološki status. U odnosu na serološki status i spol, razlike nisu znatne.