Sengupta Raj, Stone Millicent A
Royal National Hospital for Rheumatic Diseases in Bath, UK.
Nat Clin Pract Rheumatol. 2007 Sep;3(9):496-503. doi: 10.1038/ncprheum0591.
Ankylosing Spondylitis (AS) is a chronic inflammatory arthritis that predominantly affects the axial skeleton in adolescent patients causing spinal pain and stiffness. There is a marked delay, on average 8 years, between onset of disease symptoms and clinical diagnosis. The distinction between the symptoms of mechanical and inflammatory back pain remains one of the main contributing factors for the delay in diagnosis. Several classification criteria exist to aid the diagnosis of AS, but their accuracy is poor. The Ankylosing Spondylitis Assessment Study group (ASAS) has defined a core set of domains for clinical outcome measurement in AS in order to assess the disease process in individual patients and to identify those with rapidly progressive disease. New therapies, such as the tumor necrosis factor (TNF) inhibitors, have transformed the treatment paradigm in AS, especially for those patients with aggressive disease. Thus, the definition of both patient selection criteria for these agents and the development of clinical methods to assess response to therapy have become a priority. This Review focuses on measuring the degree of disease activity, function and damage in patients with AS in an ambulatory care setting, and the assessment of suitability of various outcome measures for monitoring response to treatment with TNF inhibitors.
强直性脊柱炎（AS）是一种慢性炎症性关节炎，主要影响青少年患者的中轴骨骼，导致脊柱疼痛和僵硬。从疾病症状出现到临床诊断之间平均有8年的明显延迟。机械性背痛和炎性背痛症状之间的区别仍然是诊断延迟的主要因素之一。现有几种分类标准有助于AS的诊断，但准确性较差。强直性脊柱炎评估研究组（ASAS）已经定义了一组核心领域用于AS临床结局测量，以便评估个体患者的疾病进程，并识别那些疾病快速进展的患者。新的治疗方法，如肿瘤坏死因子（TNF）抑制剂，已经改变了AS的治疗模式，特别是对于那些病情严重的患者。因此，确定这些药物的患者选择标准以及开发评估治疗反应的临床方法已成为当务之急。本综述重点关注在门诊护理环境中测量AS患者的疾病活动度、功能和损伤程度，以及评估各种结局指标对监测TNF抑制剂治疗反应的适用性。
