Akdeniz Orhan, Alayli Gamze, Tosun Fevziye Canbaz, Diren Bariş, Cengiz Kivanç, Selçuk Mustafa Bekir, Sünter Tevfik, Cantürk Ferhan
Department of Physical Medicine and Rehabilitation, Medical Faculty, Ondokuz Mayis University, Samsun, Turkey.
Clin Rheumatol. 2008 Apr;27(4):469-74. doi: 10.1007/s10067-007-0730-y. Epub 2007 Sep 15.
There are no specific diagnostic tests or a gold standard method for measuring disease activity and outcome in spondyloarthropathies (SpA). Many different methods have been developed to assess the signs and symptoms in SpA. The aim of this study was to evaluate the value of scintigraphy, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Bath Ankilosing Spondylitis Disease Activity Index (BASDAI) in the evaluation of disease activity in early axial SpA diagnosed with magnetic resonance imaging (MRI). Thirty early MRI-positive axial SpA patients (23 males, 7 females) with a median age of 35 (18-55) years and a median duration of inflammatory low back pain of 24 (8-60) months were included in the study. In the patients with sacroiliitis, the sensitivity, specificity, and positive and negative predictive values of disease activity parameters were determined regarding MRI as the gold standard method. The sensitivities of quantitative scintigraphy, visual scintigraphy, ESR, CRP, and BASDAI were 32, 82, 35, 71, and 60%, respectively. The specificities of quantitative scintigraphy, ESR, CRP, and BASDAI were 100, 100, 50, and 100%, respectively. The positive predictive values of quantitative scintigraphy, visual scintigraphy, ESR, CRP, and BASDAI were 100, 92, 100, 95, and 100%, respectively. The negative predictive values of quantitative scintigraphy, ESR, CRP, and BASDAI were 9, 10, 11, and 15%, respectively. Regarding MRI as the gold standard in the evaluation of disease activity, combined visual and quantitative bone scintigraphy can be valuable in patients with MRI-incompatible implants. Additionally, use of cheaper, simple, and readily reproducible tests such as CRP and BASDAI together could be valuable and practical in detecting disease activity in long-term follow-up of these patients.
在脊柱关节炎（SpA）中，尚无用于测量疾病活动度和预后的特定诊断试验或金标准方法。人们已开发出许多不同方法来评估SpA的体征和症状。本研究的目的是评估骨闪烁显像、红细胞沉降率（ESR）、C反应蛋白（CRP）和巴斯强直性脊柱炎疾病活动指数（BASDAI）在评估经磁共振成像（MRI）诊断的早期轴向SpA疾病活动度中的价值。该研究纳入了30例早期MRI阳性的轴向SpA患者（23例男性，7例女性），中位年龄为35（18 - 55）岁，炎性下背痛的中位病程为24（8 - 60）个月。在骶髂关节炎患者中，以MRI作为金标准方法，确定疾病活动度参数的敏感性、特异性以及阳性和阴性预测值。定量骨闪烁显像、视觉骨闪烁显像、ESR、CRP和BASDAI的敏感性分别为32%、82%、35%、71%和60%。定量骨闪烁显像、ESR、CRP和BASDAI的特异性分别为100%、100%、50%和100%。定量骨闪烁显像、视觉骨闪烁显像、ESR、CRP和BASDAI的阳性预测值分别为100%、92%、100%、95%和100%。定量骨闪烁显像、ESR、CRP和BASDAI的阴性预测值分别为9%、10%、11%和15%。在以MRI作为疾病活动度评估的金标准时，视觉和定量骨闪烁显像联合应用对有MRI不兼容植入物的患者可能有价值。此外，在这些患者的长期随访中，将CRP和BASDAI等更便宜、简单且易于重复的检查联合使用，在检测疾病活动度方面可能既有用又实用。
