目的:评估青少年特发性关节炎(JIA)和健康对照者的酒精/烟草/非法药物使用和性功能。
方法:选取儿童风湿性疾病青少年174例。一项针对54名JIA患者和35名对照的横断面研究包括人口统计学/人体测量数据和青春期标志物评估,医生进行的CRAFFT(汽车/放松/独自/忘记/朋友/麻烦)屏幕工具,用于药物滥用/依赖高风险和评估性功能的问卷,欺凌和酒精/烟草/非法药物使用。JIA还评估了临床/实验室数据和治疗。
结果:JIA患者和对照组的中位当前年龄相似[15(10-19)与15(12-18)年,p=0.506]。在JIA和对照组中,酒精/烟草/非法药物的使用频率很高,并且相似(43%vs.46%,p=0.829)。然而,JIA患者的饮酒年龄明显较高[15(11-18)与14(7-18)年,p=0.032],特别是在脊髓灰质炎发作(p=0.040)。两组均发现药物滥用/依赖的高风险(CRAFFT评分≥2)(13%vs.15%,p=1.000),同样的欺凌(p=0.088)。对JIA患者关于酒精/烟草/非法药物使用的进一步分析表明,当前年龄中位数[17(14-19)与13(10-19)年,p<0.001]和教育年限[11(6-13)vs.7(3-12)年,p<0.001]在使用物质的那些中显著较高。前一组的性活动明显更高(48%vs.7%,p<0.001)。JIA患者的CRAFFT评分与当前年龄呈正相关(p=0.032,r=0.296)。
结论:在JIA和对照组中都观察到药物滥用/依赖的高风险。JIA物质使用者更有可能发生性交。因此,建议在JIA青少年的所有就诊中进行常规筛查。
OBJECTIVE: to evaluate alcohol/tobacco/illicit drug use and sexual function in adolescent juvenile idiopathic arthritis (JIA) and healthy controls.
METHODS: 174 adolescents with pediatric rheumatic diseases were selected. A cross-sectional study with 54 JIA patients and 35 controls included demographic/anthropometric data and puberty markers assessments, physician-conducted CRAFFT (car/relax/alone/forget/friends/trouble) screen tool for substance abuse/dependence high risk and a questionnaire that evaluated sexual function, bullying and alcohol/tobacco/illicit drug use. Clinical/laboratorial data and treatment were also assessed in JIA.
RESULTS: The median current age was similar between JIA patients and controls [15(10-19) vs. 15(12-18)years, p=0.506]. Frequencies of alcohol/tobacco/illicit drug use were high and similar in both JIA and controls (43% vs. 46%, p=0.829). However, age at alcohol onset was significantly higher in those with JIA [15(11-18) vs. 14(7-18)years, p=0.032], particularly in poliarticular onset (p=0.040). High risk for substance abuse/dependence (CRAFFT score≥2) was found in both groups (13% vs. 15%, p=1.000), likewise bullying (p=0.088). Further analysis of JIA patients regarding alcohol/tobacco/illicit drug use showed that the median current age [17(14-19) vs. 13(10-19)years, p<0.001] and education years [11(6-13) vs. 7(3-12)years, p<0.001] were significant higher in those that used substances. Sexual activity was significantly higher in the former group (48% vs. 7%, p<0.001). A positive correlation was evidenced between CRAFFT score and current age in JIA patients (p=0.032, r=+0.296).
CONCLUSIONS: A high risk for substance abuse/dependence was observed in both JIA and controls. JIA substance users were more likely to have sexual intercourse. Therefore, routine screening is suggested in all visits of JIA adolescents.