目的 :探讨强直性脊柱炎(ankylosing spondylitis,AS)患者腰椎骨化程度和后凸程度与生活质量的相关性。方法:从2011年4月~2014年10月在我院就诊的AS患者中筛选出具有完整临床资料的患者106例,其中男98例,女8例;年龄36.4±9.5岁(20~64岁);病程12.4±7.5年(1~37年)。临床资料包括患者的年龄、发病年龄、病程、全脊柱最大后凸角(global kyphosis,GK)、Oswestry功能障碍指数(Oswestry disability index,ODI)、Bath AS疾病活动性指数(Bath ankylosing spondylitis disease activity index,BASDAI)、Bath AS功能指数(Bath ankylosing spondylitis functional index,BASFI)、血沉(ESR)和C反应蛋白(CRP)。应用Stoke脊柱病变评分(Stoke ankylosing spondylitis spinal score,SASSS)评估AS患者腰椎韧带骨化情况。根据SASSS分组:A组,SASSS≤36分;B组,SASSS〉36分。运用独立样本t检验比较两组间各参数的差异;采用Pearson相关性检验分析各临床参数间的相关性,寻找导致SASSS增加的危险因素。结果:A组61例患者,男58例,女3例,SASSS得分18.6±9.4分;B组45例患者,男40例,女5例,SASSS得分59.1±21.4分。两组患者年龄、病程、GK和BASFI有显著性差异(P〈0.05);而发病年龄、ODI、BASDAI、ESR、CRP无显著性差异(P〉0.05)。AS患者的SASSS与年龄、病程、GK、ODI及BASFI显著相关(r=0.505、0.650、0.414、0.219、0.319,P〈0.05);病程、SASSS和GK均与ODI和BASFI显著相关(r=0.228、0.219、0.230,P〈0.05;r=0.258、0.319、0.314,P〈0.05)。结论:年龄增加、病程延长和GK增大可能是AS患者腰椎韧带骨化程度增加的危险因素;AS患者腰椎骨化程度增加和后凸畸形加重会显著降低患者生活质量。
Objectives: To investigate the correlations of lumbar syndesmophytes and global kyphosis with quality of life in ankylosing spondylitis(AS) patients. Methods: From April 2011 to October 2014, 106 AS patients were included. There were 98 males and 8 females, with an average age of 36.4 ±9.5 years(range,20-64 years) and a mean disease duration of 12.4 ±7.5 years(1-37 years). The clinical data consisted of age,age of onset, disease duration, global kyphosis(GK), Oswestry disability index(ODI), Bath ankylosing spondylitis disease activity index(BASDAI), Bath ankylosing spondylitis functional index(BASFI), erythrocyte sedimentation rate(ESR) and C-reaction protein(CRP). Lumbar syndesmophytes were evaluated by Stoke ankylosing spondylitis spinal score(SASSS). The subjects were divided into group A and group B according to SASSS(group A,SASSS≤36; group B, SASSS〉36). The differences of the parameters between group A and group B were analyzed by the independent t-test. Pearson correlation was used to evaluate the relationships among clinical pa-rameters and to investigate the risk factors correlated with SASSS. Results: 61 AS patients were included in group A(58 males and 3 females) and the mean SASSS score was 18.6±9.4. 45 AS patients were included in group B(40 males and 5 females) and the mean SASSS score was 59.1±21.4. Age, disease duration, GK and BSFI were observed significantly different between group A and group B(P〈0.05); age of onset, ODI, BASDAI,ESR, and CRP were observed no significantly different between group A and group B(P〉0.05). Age, disease duration, GK, ODI and BSFI were found significantly correlated with SASSS(r =0.505, 0.650, 0.414, 0.219,0.319; P〈0.05). Disease duration, SASSS and GK were remarkably correlated with ODI(r=0.228, 0.219, 0.230;P 〈0.05) and BASFI(r =0.258, 0.319, 0.314; P 〈0.05). Conclusions: Older age, longer disease duration and larger GK are high risk factors of SASSS in AS patients. The