類風濕性關節炎病患最大攝氧量及生活品質之關係－－初步報告

The relationship between peak oxygen consumption and quality of life in patients with rheumatoid arthritis – a preliminary report

研究背景：類風濕性關節炎（RA）對病患的影響不僅在關節，全身其他部位也會遭受侵犯。由於病情會逐漸惡化及不可知的預後，對病患及家屬也會造成身心壓力。近期文獻回顧也發現RA比一般人較易得心血管疾病（尤其是心肌梗塞），而且身體質量組成（BMI）愈低愈易發生，同時其體適能也較一般人為差。所以本研究即在探討RA病患其生活品質及最大攝氧量之關係，以期提昇臨床對RA整體醫療照顧的品質。方法：共有50位RA患者參與本研究。每位患者均接受運動心肺功能測試並填寫WHOQOL-BREF台灣版問卷，我們用Pearson’s correlation coefficient來評估兩者之間的相關性，同時也評估BMI與最大攝氧量間的相關性。結果：平均肺活量為預估值的87.76%（正常範圍），平均最大攝氧量為23.57 ± 6.35 mL/kg/min （國人正常無規律運動之60歲男性為26 mL/kg/min） ，平均有氧缺損比率（%FAI）約為23.36 ± 13.92，而生活品質的範疇轉換平均約在60分上下（滿分為100分，愈高表示生活品質愈好） ，最大攝氧量與範疇一（生理健康）、範疇二（心理）以及範疇四（環境）有正相關，其p值分別為<0.001、0.008、0.044，而範疇三（社會關係）無相關（p值為0.350），而最大攝氧量與身體質量組成則呈負相關（p值為0.006），BMI與生活並無相關性。結論：由上述結果顯示，RA患者在接受藥物控制疾病的進展外，也應接受健康體適能的復健訓練，以提升體適能並改善生活品質。

Background: Rheumatoid arthritis (RA), a systemic disease, not only affects patients’ joints but also involves other organ systems. Due to its progressive nature and unpredictable prognosis, RA imposes physical and emotional stresses on patients and their families. Recent literature indicated that RA patients were more susceptible to cardiovascular diseases (especially myocardial infarction), particularly those with a lower body mass index (BMI), and that they also had worse physical fitness than the normal population. This study aimed to investigate the relationship between quality of life and peak oxygen consumption in RA patients, in order to improve the quality of care for these patients. Methods: Fifty patients were enrolled into this study. Each patient underwent exercise cardiopulmonary tests and filled out the questionnaire, WHOQOL-BREF, Taiwan version. The relationship between the parameters of the exercise, cardiopulmonary tests and the variables of the WHOQOL-BREF questionnaire was evaluated by Pearson’s correlation coefficient. At the same time, the relationship between BMI and peak oxygen consumption was also evaluated. Results: The average value of vital capacities was 87.76% (normal) of age and body height-matched predicted values. The average peak oxygen consumption value was 23.57 ± 6.35 mL/kg/min and the average percentage of functional aerobic deficit was about 23.36 ± 13.92. The average quality of life points derived from the results of the questionnaire were 60. The peak oxygen consumption was correlated with the results of physical wellness, mental wellness and environmental health, but not social relationship with p values of <0.001, 0.01, 0.04, and 0.35, respectively. BMI was not correlated with quality of life. Conclusion: In addition to medical control of disease activity, patients with RA should also undergo rehabilitation to improve physical fitness and quality of life.