反应性关节炎(ReA)是关节外感染后的无菌关节炎,通常在胃肠道或泌尿生殖道。这项研究的目的是评估ReA的发病率以及临床和治疗特征,并将其与历史队列进行比较。我们假设卫生的改善以及性传播感染的预防和治疗可能降低了ReA的发生率。
对2002年1月至2012年12月在南里昂和贝桑松大学医院中心诊断的所有ReA患者进行回顾性研究,并与1986年1月至1996年12月在同一两家医院诊断的ReA患者进行比较。检查了医疗记录,临床特征,分析治疗和结局,并将诊断与国际诊断标准进行比较.
在2002年至2012年期间纳入了27名患者,而在1986年至1996年期间纳入了31名患者。在风湿病科住院的患者中,ReA的总体发生率没有变化,虽然目前的演变是更严重的发展慢性疾病的形式更频繁的脊柱关节炎。虽然沙眼衣原体的发病率有所下降,现在发现了新的微生物。
ReA仍然存在,其发病率在过去30年中保持稳定。然而,ReA目前更常进展为脊柱关节炎。我们的研究还强调了准确检测ReA的诊断标准的必要性。
Reactive arthritis (ReA) is a sterile arthritis following an extra-articular infection, usually of the gastrointestinal or genitourinary tract. The aim of this
study was to assess the incidence and the clinical and therapeutic characteristics of ReA and to compare them with those of a historical cohort. We hypothesised that improved hygiene together with prevention and treatment of sexually transmitted infections may have decreased the incidence of ReA.
All patients with ReA diagnosed in the University Hospital Centres of Lyon Sud and Besançon from January 2002 to December 2012 were included in the
study retrospectively and were compared with ReA patients diagnosed from January 1986 to December 1996 in the same two hospitals. Medical records were reviewed, clinical features, treatments and outcomes were analysed and diagnoses were compared with international diagnostic criteria.
Twenty-seven patients were included between 2002 and 2012 compared with 31 between 1986 and 1996. The overall incidence of ReA in patients hospitalised in the rheumatology department did not change, although the current evolution is more severe with development of chronic disease in the form of more frequent spondyloarthritis. While the incidence of Chlamydiae trachomatis has decreased, new microbes are now found to be involved.
ReA still exists and its incidence has been stable over the last 30 years. However, ReA currently more often progress to spondyloarthritis. Our
study also highlights the need for diagnostic criteria that accurately detect ReA.