背景與目的
類風濕性關節炎(RA)是一種慢性的自身免疫性疾病，以關節滑膜炎及對稱性、破壞性的關節病變為主要特徵。類風濕性關節炎發病機轉複雜，目前多認為是遺傳因素和環境因素共同作用而引起。據先前研究統計，約90%的患者對氣候變化敏感，，且有研究指出在氣候濕度變化大的地區，類風濕性關節炎的患病率高；有些患者在天氣變化時症狀加重。因此，本研究目的為探討氣候條件對類風溼性關節炎的影響。

材料與方法
本研究使用衛生福利部健保資料庫1996-2013年之100萬歸人檔，篩選診斷為類風濕性關節炎(ICD-9-CM=714.0)的病患，分析2009-2013年間類風濕性關節炎病患就醫紀錄與中央氣象局收集之氣候資料間的相關性。本研究並進一步將病患依據使用一線治療或二線治療藥物分成輕度與重度兩組，觀察氣候條件是否在不同組別對疾病疼痛會有不同程度的影響，另使用時間序列分析法中的自迴歸分析探討氣象因子對就醫次數的影響。本研究統計分析使用SAS 9.4，統計檢定設定為雙尾檢定，顯著水準為0.05。結果單變量線性回歸分析結果發現就醫次數與氣溫、雨量、相對溼度、日照時數、風速皆有顯著相關性。自回歸分析結果顯示就醫次數與氣溫及雨量相關性最佳；氣溫及雨量上升時，就醫人數增加。時間序列分析顯示各氣象因子對就醫次數的遲滯效應皆為0~1天。

結論
類風溼性關節炎患者的就醫次數會受到天氣影響，且各氣象因子對就醫次數的影響存在遲滯效應。

Many patients with rheumatic diseases claim that they feel worse before or during weather changes. However, investigation of such claims encounters with several methodological challenges. For example, the sample size is generally small, and subjective variables like pain are likely to be affected by reporting biases. Not surprisingly, previous studies have yielded controversial and contradictory results. Our study used the Taiwan National Health Insurance Research Database 2000 (LHID2000), providing an adequate sample size and can ensuring that patients are blinded to our research question. We use the records of outpatient visits from 2009-2013 in LHID2000 and weather reports from the Central Weather Bureau to perform regression analyses. We found that the frequency of rheumatoid arthritis outpatient visits was significantly correlated with temperature, humidity, wind speed, and sunshine duration. The time-series analysis showed that temperature and precipitation were the significant predictors of the frequency of rheumatoid arthritis outpatient visits. Specifically, when temperature and precipitation rose, the frequency of outpatient visits increased. The lag effects weather factors varied from 0-1 day. Our study showed that outpatient visits paid by patients with rheumatoid arthritis were affected by weather factors.

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