SF-36量表和临床评价指标在强直性脊柱炎队列研究中的应用价值

Clinical value of Short Form-36 and clinical measures in a prospective cohort study of ankylosing spondylitis patients

目的通过分析强直性脊柱炎（As）患者的基线期数据及随访数据，探讨SF-36量表和几种常用临床评价指标在AS前瞻性队列随访研究中的临床应用价值。方法对2013年8月至2015年9月就诊于解放军总医院风湿科门诊的517例AS患者的生活质量采用SF-36量表进行评价并与我国一般人群进行对比，同时探讨BathAS疾病活动指数（BASDAI）、Bath强直性脊柱炎功能指数（BASFI）、BathAS测量指数（BASMI）等临床评价指标与患者生活质量的相关性及其临床应用价值。结果BASDAI、BASFI是与SF-36量表各维度相关最密切的临床参数（r〉0．3，P〈0．01）。Logistic多元回归分析显示，BASDAI、BASFI、BASMI和文化程度是各项临床评价指标中可能影响患者基线期总体生命质量、生理健康和心理健康的关键因素。BASDAI得分变化是影响AS患者总体生活质量、生理健康和心理健康变化的最重要因素（OR分别为0．235，0．209，0．125；P〈0．01）。结论SF-36量表可以客观地反映AS患者的生活质量现况。BASDAI、BASFI等临床评价指标在AS的前瞻性队列研究中具有重要的临床应用价值。

Objective To evaluate the clinical value of Short Form-36 （SF-36） questionnaire and the most commonly used clinical measures in a prospective cohort study of ankylosing spondylitis （AS） patients. Methods A total of 517 AS patients were collected from the Department of Rheumatology, Chinese PLA General Hospital from August 2013 to September 2015. The Quality of Life （QoL） was assessed by SF-36 questionnaire and compared with the general population. The correlations between QoL and clinical measures of AS, including the Bath AS disease activity index （ BASDAI）, Bath AS functional index （BASFI）, Bath AS metrology index （BASMI） et al, were analyzed. Results BASDAI and BASFI were significantly correlated with SF-36 scores （ r 〉 0. 3, P 〈 0.01 ）. Logistic multiple regression analysis showed that BASDAI, BASFI, BASMI and education had close correlation with the baseline global QoL, physical and mental health. Among these clinical measures, BASDAI variation showed the most important influence on the change of global QoL, physical health and mental health （OR =0. 235, 0. 209, 0. 125; P 〈 0. 01 ）. Conclusions SF-36 can objectively reflect the QoL of patients with AS. Clinical measures such as BASDAI and BASFI show great application value in this prospective cohort study of AS patients.