强直性脊柱炎患者腰椎骨化程度和后凸程度与生活质量的相关性分析

Correlation analysis of lumbar syndesmophytes, global kyphosis and quality of life in ankylosing spondylitis patients

目的 ：探讨强直性脊柱炎（ankylosing spondylitis,AS）患者腰椎骨化程度和后凸程度与生活质量的相关性。方法：从2011年4月~2014年10月在我院就诊的AS患者中筛选出具有完整临床资料的患者106例,其中男98例,女8例;年龄36.4±9.5岁（20~64岁）;病程12.4±7.5年（1~37年）。临床资料包括患者的年龄、发病年龄、病程、全脊柱最大后凸角（global kyphosis,GK）、Oswestry功能障碍指数（Oswestry disability index,ODI）、Bath AS疾病活动性指数（Bath ankylosing spondylitis disease activity index,BASDAI）、Bath AS功能指数（Bath ankylosing spondylitis functional index,BASFI）、血沉（ESR）和C反应蛋白（CRP）。应用Stoke脊柱病变评分（Stoke ankylosing spondylitis spinal score,SASSS）评估AS患者腰椎韧带骨化情况。根据SASSS分组：A组,SASSS≤36分;B组,SASSS〉36分。运用独立样本t检验比较两组间各参数的差异;采用Pearson相关性检验分析各临床参数间的相关性,寻找导致SASSS增加的危险因素。结果：A组61例患者,男58例,女3例,SASSS得分18.6±9.4分;B组45例患者,男40例,女5例,SASSS得分59.1±21.4分。两组患者年龄、病程、GK和BASFI有显著性差异（P〈0.05）;而发病年龄、ODI、BASDAI、ESR、CRP无显著性差异（P〉0.05）。AS患者的SASSS与年龄、病程、GK、ODI及BASFI显著相关（r=0.505、0.650、0.414、0.219、0.319,P〈0.05）;病程、SASSS和GK均与ODI和BASFI显著相关（r=0.228、0.219、0.230,P〈0.05;r=0.258、0.319、0.314,P〈0.05）。结论：年龄增加、病程延长和GK增大可能是AS患者腰椎韧带骨化程度增加的危险因素;AS患者腰椎骨化程度增加和后凸畸形加重会显著降低患者生活质量。

Objectives： To investigate the correlations of lumbar syndesmophytes and global kyphosis with quality of life in ankylosing spondylitis（AS） patients. Methods： From April 2011 to October 2014, 106 AS patients were included. There were 98 males and 8 females, with an average age of 36.4 ±9.5 years（range,20-64 years） and a mean disease duration of 12.4 ±7.5 years（1-37 years）. The clinical data consisted of age,age of onset, disease duration, global kyphosis（GK）, Oswestry disability index（ODI）, Bath ankylosing spondylitis disease activity index（BASDAI）, Bath ankylosing spondylitis functional index（BASFI）, erythrocyte sedimentation rate（ESR） and C-reaction protein（CRP）. Lumbar syndesmophytes were evaluated by Stoke ankylosing spondylitis spinal score（SASSS）. The subjects were divided into group A and group B according to SASSS（group A,SASSS≤36; group B, SASSS〉36）. The differences of the parameters between group A and group B were analyzed by the independent t-test. Pearson correlation was used to evaluate the relationships among clinical pa-rameters and to investigate the risk factors correlated with SASSS. Results： 61 AS patients were included in group A（58 males and 3 females） and the mean SASSS score was 18.6±9.4. 45 AS patients were included in group B（40 males and 5 females） and the mean SASSS score was 59.1±21.4. Age, disease duration, GK and BSFI were observed significantly different between group A and group B（P〈0.05）; age of onset, ODI, BASDAI,ESR, and CRP were observed no significantly different between group A and group B（P〉0.05）. Age, disease duration, GK, ODI and BSFI were found significantly correlated with SASSS（r =0.505, 0.650, 0.414, 0.219,0.319; P〈0.05）. Disease duration, SASSS and GK were remarkably correlated with ODI（r=0.228, 0.219, 0.230;P 〈0.05） and BASFI（r =0.258, 0.319, 0.314; P 〈0.05）. Conclusions： Older age, longer disease duration and larger GK are high risk factors of SASSS in AS patients. The quality of life in AS patients is severely affected by the higher SASSS and larger GK.