应用SF-36量表评估中轴型SpA患者非甾体抗炎药治疗后生活质量变化

Changes of quality of life in patients with ax-SpA treated with non-steroidal anti-inflammatory drugs evaluated by the SF-36

目的:应用36条简明健康状况调查量表(SF-36量表)评估中轴型脊柱关节炎(中轴型Sp A)患者应用非甾体抗炎药(NSAIDs)治疗后生活质量的变化情况。方法:选择2014年10月~2015年9月在郑州大学第一附属医院确诊为中轴型Sp A的患者120例。均同意使用指定药物及指定量表评估,并签署知情同意书。采用随机、双盲、平行对照的方法,通过单纯随机分组,将120人分为艾瑞昔布组和塞来昔布组,均为每次200 mg,每天2次,治疗3个月。采用中文版SF-36量表评估中轴型Sp A患者NSAIDs治疗前后的生活质量变化情况。分析生活质量和血沉(ESR)、C反应蛋白(CRP)、Bath AS疾病活动指数(BASDAI)、Bath强直性脊柱炎功能指数(BASFI)、加拿大脊柱关节炎研究协会评分(SPARCC)之间的相关性。结果:中轴型Sp A患者116人完成最终评估,4人失访。应用SF36量表评估中轴型Sp A患者NSAIDs治疗3个月前后生活质量变化,两种药物治疗效果的对比差异无统计学意义(P>0.05)。总体患者NSAIDs治疗3个月后,生理功能、生理职能、躯体疼痛、总体健康、社会功能、情感职能与治疗前差异有统计学意义(P<0.05);活力、精神健康,差异无统计学意义(P>0.05)。BASDAI与PF、RP、BP、GH、VT、SF、RE呈正相关(P<0.05);BASDAI与MH无明显相关性(P>0.05);BASFI与PF、RP、BP、GH、SF、RE、MH呈正相关(P<0.05);BASFI与VT无明显相关性(P>0.05)。ESR只与SF、RE呈正相关(P<0.05);CRP只与SF、MH呈正相关(P<0.05);SPARCC只与PF呈正相关(P<0.05)。BASDAI、BASFI是影响PF的重要影响因素(P<0.05);BASDAI是影响BP、GH、VT、RE的重要影响因素(P<0.05);BASFI是影响RP、SF、MH的重要影响因素(P<0.05)。结论:非甾体抗炎药能改善中轴型Sp A患者的生活质量,艾瑞昔布和塞来昔布疗效相当;SF-36量表适用于评估中轴型Sp A患者的生活质量。

Objective： To evaluate the changes of quality of life in patients with axial spondyloarthritis （ax-SpA） after treatment with non-steroidal anti-inflammatory drugs （NSAIDs） by the 36-item Short Form Health Survey （SF-36）. Methods： 120 patients diagnosed with ax-SpA were collected in the first Affiliated Hospital of Zhengzhou University from October 2014 to September 2015. They all agreed to be treated with the special drugs and assessed by special scale. Then they all signed the agreement. In the 3 months, double-blind, parallel controlled trial patients were randomized to 200 mg twice daily （bid） imrecoxib, or 200 mg twice daily （bid） celecoxib. They were assessed for the changes of quality of life at enrollment and after three months of NSAIDs therapy by the SF- 36 of Chinese edition. The correlation between quality of life and erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP）, Bath Ankylosing Spondylitis Disease Activity Index （BASDAI）, Bath Ankylosing Spondylitis Functional Index （BASFI）, Spondylo Arthritis Research Consortium of Canada （SPARCC） was analyzed. Results： A total of 116 ax-SpA patients completed the study and 4 patients were lost to follow-up. We used the SF-36 scale to assess the quality of life in patients with ax-SpA before and after 3 months, NSAIDs treatment. The treatment effects were not statistically significant difference between the two drugs （P〉0. 05 ）. After all the patients were treated with NSAIDs for 3 months, there was statistically significant difference （P〈0. 05 ） of the physical functioning, role-physical,bodily pain, general health, social functioning, role-emotional ; and there was no statistically significant difference （ P〉0. 05 ） of vitality and mental health. The positively significant correlations had been identified between BASDAI and PF, RP, Bp, GH, VT, SF,RE （P〈0. 05 ） ,while no significant correlation was found between BASDAI and MH （P〉0. 05 ）. A positively significant correlation had been i- dentified between BASFI and PF, RP, BP, GH, SF, RE, MH （P〈0. 05 ）, while no significant correlation was found between BASFI and VT （P〉0. 05 ）. The ESR was positively correlated with SF, RE （P〈0. 05 ） ;and CRP was positively correlated with SF, MH （P〈0. 05 ） ; and SPARCC was positively correlated with PF （ P〈0. 05 ）. BASDAI and BASFI were the important influence factors of PF （P〈0. 05） ; and BASDAI was the important influence factor of BP, GH, VT, RE （P〈0. 05） ; BASFI was the important influence factor of RP, SF, MH （P〈0. 05）. Conchmion： Non-steroidal anti-inflammatory drugs can improve the quality of life of the ax-SpA patients. Imrecoxib and celecoxib have the equivalent curative effect. SF36 scale is suitable for the assessment of the quality of life in patients with ax-SpA.