Falkenbach Albrecht, Franke Annegret, van der Linden Sjef
Gasteiner Heilstollen Hospital, A-5645 Bad Gastein, Austria.
J Rheumatol. 2003 Oct;30(10):2186-92.
To determine for patients with ankylosing spondylitis (AS) which factors are associated with disability and restricted body function.
In 1538 patients with AS, occiput-to-wall distance, chest expansion, cervical rotation, finger-floor distance, and modified Schober test were measured cross-sectionally, and for each measure the patient's respective percentile was calculated. The mean of the 5 percentiles was summarized in the mobility restriction score (MRS). In addition, patients answered questions on disease progression and completed the Bath AS Functional Index (BASFI) questionnaire. All data were coded into 40 variables, used as independent variables in multiple regression analyses to identify factors associated with BASFI and MRS.
Finger-to-floor distance (beta positive, +), cervical rotation (-), time since first AS symptoms (-), age (+), height loss (+), maximum height (-), delay in diagnosis (+), hip replacement (+), regular practice of sports (-), chest expansion (-), sex (worse BASFI in females), exposure to cold and dampness (+), and regular participation in AS group physical exercises (+) were significantly associated with worse BASFI. Significantly associated factors for worse MRS were height loss (+), sex (higher MRS in males), active inflammation of the cervical region (+), age (+), maximum height (-), active inflammation of the hip region (+), involvement of shoulders (+), time since first AS symptoms (+), urethritis (-), regular practice of sports (-), involvement of feet (-), and hip replacement (+). The models explain 47% of the variance observed for both the BASFI and MRS.
The amount of variance explained for both BASFI and MRS is rather high. The results apply primarily to groups of patients, but are insufficient to guide clinical decisions in individual patients. These findings contribute to our understanding of factors influencing disability and restriction in body function in AS.
确定强直性脊柱炎（AS）患者中哪些因素与残疾和身体功能受限相关。
对1538例AS患者进行枕墙距、胸廓活动度、颈椎旋转度、指地距和改良Schober试验的横断面测量，并计算每个测量指标的患者相应百分位数。将5个百分位数的平均值汇总为活动受限评分（MRS）。此外，患者回答有关疾病进展的问题并完成巴斯强直性脊柱炎功能指数（BASFI）问卷。所有数据被编码为40个变量，用作多元回归分析中的自变量，以确定与BASFI和MRS相关的因素。
指地距（β为正，+）、颈椎旋转度（-）、首次出现AS症状后的时间（-）、年龄（+）、身高降低（+）、最高身高（-）、诊断延迟（+）、髋关节置换（+）、定期进行体育锻炼（-）、胸廓活动度（-）、性别（女性BASFI更差）、接触寒冷和潮湿（+）以及定期参加AS组体育锻炼（+）与更差的BASFI显著相关。与更差的MRS显著相关的因素有身高降低（+）、性别（男性MRS更高）、颈椎区域的活动性炎症（+）、年龄（+）、最高身高（-）、髋关节区域的活动性炎症（+）、肩部受累（+）、首次出现AS症状后的时间（+）、尿道炎（-）、定期进行体育锻炼（-）、足部受累（-）和髋关节置换（+）。这些模型解释了BASFI和MRS观察到的47%的方差。
BASFI和MRS所解释的方差量相当高。结果主要适用于患者群体，但不足以指导个体患者的临床决策。这些发现有助于我们理解影响AS患者残疾和身体功能受限的因素。
