强直性脊柱炎髋关节病变的相关因素

Related factors of hip joint lesions in ankylosing spondylitis

目的分析强直性脊柱炎(AS)并发髋关节病变患者的临床资料,探讨AS并发髋关节病变的潜在相关因素。方法对2011年1月至2015年12月在西京医院就诊的300例AS患者进行回顾性分析。基线期髋关节放射学评分≥2被定义为髋关节病变。采用单因素和多因素Logistic回归分析与AS并发髋关节病变相关的因素。结果本研究共纳入300例诊断为AS的患者。髋关节放射学评分(BASRI-hip≥2)患者占59%(177/300),男性比例为51.4%(91/177),平均年龄为(20.43±2.15)岁,平均病程为10年,HLA-B27阳性率为91%(161/177)。多变量分析表明,长病程(OR=4.9,95%CI:2.4~9.6,P<0.001)、高度疾病活动状态(OR=2.2,95%CI:1.3~5.2,P=0.001),发病年龄小(OR=2.1,95%CI:1.1~6.2,P=0.006)、髋关节功能Harris评分低(OR=1.8,95%CI:1.2~1.7,P=0.008)、步行距离短(OR=0.4,95%CI:0.20~0.8,P=0.007)与AS髋关节病变患者放射学进展程度独立相关。结论AS髋关节病变患者的放射学进展可能与病程长、发病年龄较小、高疾病活动度、步行距离短、髋关节功能差相关,随访过程中需密切观察。

Objective To analyze the clinical manifestation of ankylosing spondylitis(AS)patients with hip lesions,and to explore the potential related factors of AS complicated with hip lesions.Methods Retrospective analysis was performed on AS patients in Xijing Hospital from January 2011 to December 2015.Hip lesion was defined as a Bath radiologic hip score≥2.Univariate and multivariate Logistic regression were used to analyze the factors associated with hip lesion.Results A total of 300 AS patients were included.Patients with hip radiology score(BASRI≥2)accounted for 59%(177/300),and the proportion of males was 51.4%(91/177).The mean age was(20.43±2.15)years old,the mean duration of disease was 10 years,and the positive rate of HLA-B27 was 91%(161/177).Multivariate analysis showed that long course of disease(OR=4.9,95%CI:2.4-9.6,P<0.001)high disease activity(OR=2.2,95%CI:1.3-5.2,P=0.001),younger age of onset(OR=2.1,95%CI:1.1-6.2,P=0.006),Low Harris hip score(OR=1.8,95%CI:1.2-1.7,P=0.008),and short walking distance(OR=0.4,95%CI:0.2-0.8,P=0.007)were independently correlated with the degree of radiological progression in AS patients with hip lesion.Conclusion The radiological progress of AS patients with hip lesions may be related to the long course of disease,younger age of onset,high disease activity,short walking distance,and poor hip function,which should be closely observed during the follow-up.