Kauppi M, Konttinen Y T, Honkanen V, Sakaguchi M, Hamalainen M, Santavirta S
Department of Medicine, Oulu University Central Hospital, Finland.
Clin Rheumatol. 1991 Dec;10(4):413-8. doi: 10.1007/BF02206662.
A cross-sectional, retrospective computerized analysis of risk factors for anterior atlantoaxial subluxation (AAS) was performed. Logistic regression performed on the clinical variables involved in 145 cases of rheumatoid arthritis (RA) disclosed a high joint score index and a low blood haemoglobin level as significant independent risk factors. This means that the development of anterior AAS is connected with widespread RA. Linear multiple regression analysis showed an association between the extent of anterior AAS in millimetres and the spread of erosions of the dens of axis and negative correlation with the severity of vertical atlantoaxial dislocation (VD). This suggests that whereas the presence of anterior AAS is connected with the severity of the systemic disease, its actual extent is associated with signs of local involvement, other than severe VD. The duration or cumulative dosage of glucocorticoids were not associated with the development or extent of anterior AAS, nor with the severity of vertical dislocation. This suggests that low dose glucocorticoid treatment is not involved with the development of rheumatoid changes in the upper cervical spine. It should be borne in mind, of course, that although no correlation was found, a causal relation cannot be excluded.
对寰枢椎前脱位（AAS）的危险因素进行了一项横断面回顾性计算机分析。对145例类风湿关节炎（RA）患者的临床变量进行逻辑回归分析发现，高关节评分指数和低血红蛋白水平是显著的独立危险因素。这意味着寰枢椎前脱位的发生与广泛的类风湿关节炎有关。线性多元回归分析显示，以毫米为单位的寰枢椎前脱位程度与枢椎齿突侵蚀范围之间存在关联，且与垂直寰枢椎脱位（VD）的严重程度呈负相关。这表明，虽然寰枢椎前脱位的存在与全身疾病的严重程度有关，但其实际程度与除严重垂直脱位外的局部受累体征有关。糖皮质激素的使用时间或累积剂量与寰枢椎前脱位的发生或程度无关，也与垂直脱位的严重程度无关。这表明低剂量糖皮质激素治疗与上颈椎类风湿性改变的发生无关。当然，应该记住，虽然未发现相关性，但不能排除因果关系。
