Bostan Elif E, Borman Pinar, Bodur Hatice, Barça Nurdan
Clinic of Physical Medicine and Rehabilitation, Numune Education and Research Hospital, Samanpazari, 06100 Ankara, Turkey.
Rheumatol Int. 2003 May;23(3):121-6. doi: 10.1007/s00296-002-0261-4. Epub 2002 Oct 30.
The aim of this study was to evaluate functional disability and quality of life (QOL) in patients with ankylosing spondylitis (AS) and determine the relationship between functional status and measures of clinical condition including QOL. Fifty-one AS patients (45 male, six female) with a mean age of 37.2+/-10.8 years were included. The demographic data of the patients were recorded. Their clinical status was assessed using the Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Radiology Index (BASRI), and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Global pain of the patients was determined with a visual analog scale (VAS), and QOL status was evaluated with the Nottingham Health Profile (NHP). Twenty-seven patients (52.9%) had peripheral articular involvement. Sixty percent had mild-to-moderate and 25.4% of the patients had severe functional disability, while 5.8% did not report any functional loss. A significant change in the mean scores of all clinical measures except BASRI was observed between patients with and without peripheral arthritis. The clinical measures of disease (BASRI, BASMI, and BASDAI) were all correlated with each other and with laboratory variables. The strongest factors correlating with functional loss were BASMI and BASDAI. The scores of all sections of the NHP were significantly higher, indicating a poor quality of life in AS patients. Peripheral joint involvement had a significant role in the deterioration of QOL. Physical domains of NHP such as pain and physical activity had highest correlations with functional disability, whereas psychosocial domains of NHP were found to correlate more highly with BASDAI and VAS pain scores. These results show the effect of AS, especially when the disease is active and associated with peripheral involvement. In conclusion, current management strategies should focus on decreasing pain, maintaining physical activity, and efforts to improve psychosocial health aspects for increasing QOL in patients suffering from AS.
本研究旨在评估强直性脊柱炎（AS）患者的功能残疾和生活质量（QOL），并确定功能状态与包括QOL在内的临床状况指标之间的关系。纳入了51例AS患者（45例男性，6例女性），平均年龄为37.2±10.8岁。记录了患者的人口统计学数据。使用巴斯强直性脊柱炎测量指数（BASMI）、巴斯强直性脊柱炎放射学指数（BASRI）和巴斯强直性脊柱炎疾病活动指数（BASDAI）评估他们的临床状况。用视觉模拟量表（VAS）确定患者的总体疼痛情况，并用诺丁汉健康概况（NHP）评估QOL状况。27例患者（52.9%）有外周关节受累。60%的患者有轻度至中度功能残疾，25.4%的患者有严重功能残疾，而5.8%的患者未报告任何功能丧失。在有和没有外周关节炎的患者之间，除BASRI外的所有临床指标的平均得分均观察到显著变化。疾病的临床指标（BASRI、BASMI和BASDAI）彼此之间以及与实验室变量均相关。与功能丧失相关性最强的因素是BASMI和BASDAI。NHP所有部分的得分均显著更高，表明AS患者的生活质量较差。外周关节受累在QOL恶化中起重要作用。NHP的身体领域，如疼痛和身体活动，与功能残疾的相关性最高，而NHP的心理社会领域与BASDAI和VAS疼痛评分的相关性更高。这些结果显示了AS的影响，尤其是当疾病活跃并伴有外周受累时。总之，当前的管理策略应侧重于减轻疼痛、维持身体活动，并努力改善心理社会健康方面，以提高AS患者的QOL。
