强直性脊柱炎发生葡萄膜炎相关危险因素分析

Risk factors of uveitis in ankylosing spondylitis

目的探讨AS出现葡萄膜炎的相关危险因素。方法纳入2018年1月至12月在新疆维吾尔自治区人民医院风湿免疫科就诊并明确诊断AS患者206例。依据是否存在葡萄膜炎将AS患者分别纳入有葡萄膜炎组和无葡萄膜炎组。采用独立样本t检验、Wilcoxon秩和检验、χ^(2)检验及二元Logistic回归等对患者基本临床资料、实验室指标、影像学资料进行回顾性分析。结果有葡萄膜炎组37例,无葡萄膜炎组169例;与无葡萄膜炎组相比,有葡萄膜炎组患者年龄更大[(40±11)岁和(36±11)岁,t=-2.06,P<0.05],病程更长[(10(5,16)年和5(2,10)年,Z=-3.16,P<0.01],外周关节炎[51.4%(19/37)和32.5%(55/169),χ^(2)=4.66,P<0.05)]及外周附着点炎更常见[40.5%(15/37)和11.8%(20/169),χ^(2)=17.34,P<0.01],HLA-B27阳性率更高[100%(37/37)和85.8%(145/169),χ^(2)=5.95,P=0.01]。然而,在性别、民族、颈椎压痛、吸烟史、吸烟量、葡萄膜炎家族史、AS家族史、BMI方面2组间差异无统计学意义。血小板计数、CRP、ESR 2组间差异亦无统计学意义。通过二元Logistic回归分析得出,外周附着点炎[OR值(95%CI)=4.289(1.832,10.040),P<0.01]、病程[OR值(95%CI)=1.072(1.014,1.134),P<0.05]与AS相关葡萄膜炎独立相关。结论研究提示AS患者存在长病程、外周附着点炎时,其出现葡萄膜炎风险增加。

Objective To investigate the risk factors of uveitis in ankylosing spondylitis(AS).Methods This retrospective study included 206 patients with AS who visited the department of rheumatology and immunology of People's Hospital of Xinjiang Uygur Autonomous Region between January,2018 and December,2018.Those patients with uveitis were enrolled in the uveitis group.AS patients without uveitis were included in the non uveitis group as control.The basic clinical data,laboratory indexes and imaging data were analyzed retrospectively by t-test,Wilcoxon rank sum test,Chi square test and binary logistic regression.Results Thirty-seven patients with uveitis and 169 patients without uveitis were included.Compared with the non uveitis group,patients with uveitis were older in age[(40±11)years vs(36±11)years,t=-2.06,P<0.05],longer in disease duration[10(5,16)years vs 5(2,10)years,Z=-3.16,P<0.01],more peripheral arthritis[51.4%(19/37)vs 32.5%(55/169),χ^(2)=4.66,P<0.05]and peripheral enthesitis[40.5%(15/37)vs 11.8%(20/169),χ^(2)=17.34,P<0.01],and higher human leukocyte antigen(HLA)-B27 positive rate[100%(37/37)vs 85.8%(145/169),χ^(2)=5.95,P=0.01].However,there were no significant difference in gender,race,cervical tenderness,smoking history and volume,a positive family history of uveitis,a positive family history of AS and BMI.There was no significant difference in bloodplatelet(PLT),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR).By the binary logistic regression analysis,we found that peripheral enthesitis[OR(95%CI)=4.289(1.832,10.040),P<0.01],and longer disease duration[OR(95%CI)=1.072(1.014,1.134),P<0.05]were independently related to AS related uveitis.Conclusion This study suggests that the risk of uveitis is increased in AS patients with longer disease duration and peripheral enthesitis.