全脊柱加骶髂关节SPARCC评分对益赛普治疗强直性脊柱炎疗效的评估与预测价值

The Value of SPARCC Score of Spine and Sacroiliac Joint in Evaluating and Predicating the Efficacy of YISAIPU for the Treatment of Ankylosing Spondylitis

目的:探究全脊柱加骶髂关节SPARCC评分在评估及预测肿瘤坏死因子抑制剂(益赛普)治疗强直性脊柱炎疗效中的应用价值。方法:选取54名活动期的强直性脊柱炎患者并予以益赛普治疗,于治疗的基线期(治疗前)和12周进行临床评估及MRI检查。使用SPARCC评分系统,对患者治疗前后脊柱及骶髂骨的骨髓水肿进行评分,同时对比临床疗效评估进行研究。结果:治疗后强直性脊柱炎患者骨髓水肿的改善与疾病活动度指标ASDAS、BASDAI、CRP、ESR的改善具有相关性(P <0.05),且Kappa检验显示使用SPARCC评分评估益赛普治疗的无效、显效与临床疗效评价指标ASAS40具有一致性(Kappa值=0.514,P <0.001)。Logistic回归分析及ROC曲线显示全脊柱加骶髂关节的SPARCC评分(OR=1.086,P=0.045;AUC=0.811,P=0.005)是益赛普疗效的预测因素。结论:全脊柱加骶髂关节的SPARCC评分可以用于评估及预测益赛普对强直性脊柱炎的疗效。

Purpose: To explore the value of the SPARCC score of spine and sacroiliac joint in evaluating and predicting the efficacy of tumor necrosis factor inhibitor(YISAIPU) in the treatment of ankylosing spondylitis. Methods: Fifty-four patients with active AS were treated with YISAIPU. Clinical evaluation and MRI were performed at baseline and 12 weeks of treatment. The spine and sacroiliac joint were scored before and after treatment according to the SPARCC scoring system, and the clinical efficacy was also evaluated. Results: The improvement of bone marrow edema after treatment was correlated with the improvement of disease activity index ASDAS, BASDAI, CRP, ESR(P<0.05), and Kappa test showed that the use of SPARCC score to evaluate effectiveness of YISAIPU was consistent with ASAS40(Kappa= 0.514, P< 0.001). Logistic regression analysis and ROC curve showed that the SPARCC score of spine and sacroiliac joint(OR=1.086, P=0.045;AUC=0.811, P=0.005) was the predictor of the efficacy of YISAIPU. Conclusion: The SPARCC score of spine and sacroiliac joint can be used to assess and predict the efficacy of YISAIPU on ankylosing spondylitis.