Chen Chun-Hsiung, Lin Kuan-Chia, Chen Horng-An, Liao Hsien-Tzung, Liang Toong-Hua, Wang Hon-Pin, Chou Chung-Tei
Taipei Medial University-Municipal Wan Fang Hospital, Taipei, Taiwan.
Clin Rheumatol. 2007 Jun;26(6):953-7. doi: 10.1007/s10067-006-0403-2. Epub 2006 Oct 5.
Acute anterior uveitis (AAU) is the most frequently extra-articular manifestation of ankylosing spondylitis (AS). To investigate whether AAU has an association with disease activity, functional ability and physical mobility in AS patients, 146 Chinese AS patients in Taiwan were enrolled in a cross-sectional study. These patients fulfilled the 1984 modified New York criteria and visited the Outpatient Department of the Veterans General Hospital-Taipei from April 2004 to July 2005. Patients completed questionnaires assessing disease activity [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)], functional ability [Bath Ankylosing Spondylitis Functional Index (BASFI)] and patient's global assessment [Bath Ankylosing Spondylitis Patient Global Score (BAS-G)]. Meanwhile, physical examinations were performed, including Schober test, finger-to-floor, lateral spinal flexion, occiput-to-wall and chest expansion. The history of AAU was accepted only if diagnosed by an ophthalmologist. The prevalence of AAU in this Chinese AS cohort was 15.8% (23/146). Patients with AAU had a significantly higher BASDAI than those without [absolute differences=0.96, 95% confidence intervals (CI): 0.35-1.88]. Additionally, patients with AAU had significantly increased BASFI than those without (absolute differences=1.46, 95% CI: 0.33-2.59). Moreover, there was advanced limitation of physical motility in patients with AAU, including finger-to-floor, occiput-to-wall distances and Schober test, (95% CI: 3.89-16.95 and p=0.046, respectively). Disease duration mildly correlated with BASFI (r=0.24, p=0.003) but not with BASDAI (p=0.838). There was no difference of disease duration between patients with and without AAU (p=0.343). These results suggested that the presence of AAU in AS patients may be associated with higher disease activity, poor functional ability and advanced physical impairment.
急性前葡萄膜炎(AAU)是强直性脊柱炎(AS)最常见的关节外表现。为了研究AAU是否与AS患者的疾病活动度、功能能力和身体活动能力有关,台湾的146例中国AS患者被纳入一项横断面研究。这些患者符合1984年修订的纽约标准,并于2004年4月至2005年7月就诊于台北荣民总医院门诊部。患者完成了评估疾病活动度[巴斯强直性脊柱炎疾病活动指数(BASDAI)]、功能能力[巴斯强直性脊柱炎功能指数(BASFI)]和患者整体评估[巴斯强直性脊柱炎患者整体评分(BAS-G)]的问卷。同时,进行了体格检查,包括Schober试验、指尖触地、脊柱侧屈、枕墙距和胸廓活动度。只有经眼科医生诊断的AAU病史才被认可。该中国AS队列中AAU的患病率为15.8%(23/146)。有AAU的患者BASDAI显著高于无AAU的患者[绝对差异=0.96,95%置信区间(CI):0.35 - 1.88]。此外,有AAU的患者BASFI显著高于无AAU的患者(绝对差异=1.46,95%CI:0.33 - 2.59)。而且,有AAU的患者身体活动能力存在更严重的受限,包括指尖触地、枕墙距和Schober试验(95%CI分别为:3.89 - 16.95和p = 0.046)。病程与BASFI轻度相关(r = 0.24,p = 0.003),但与BASDAI无关(p = 0.838)。有AAU和无AAU的患者病程无差异(p = 0.343)。这些结果表明,AS患者中AAU的存在可能与更高的疾病活动度、较差的功能能力和更严重的身体损害有关。