Stone M A, Pomeroy E, Keat A, Sengupta R, Hickey S, Dieppe P, Gooberman-Hill R, Mogg R, Richardson J, Inman R D
Royal National Hospital for Rheumatic Diseases NHS Foundation Trust, Upper Borough Walls, Bath BA1 1RL, UK.
Rheumatology (Oxford). 2008 Aug;47(8):1213-8. doi: 10.1093/rheumatology/ken176. Epub 2008 Jun 6.
Many AS patients report periods of perceived higher disease activity (flares). This pilot study aims to document disease activity patterns reported by AS patients and examine associations with disease-specific health status measures.
Consecutive AS patients (n = 114) were asked whether they experience flares, and if they experience symptoms of AS between flares. They were shown the Flare Illustration of disease patterns over time and asked to select the pattern that best described their disease (i) since symptom onset and (ii) in the past year. Associations between reported disease pattern and disease activity (Bath AS Disease Activity Index, BASDAI); functional impairment (Bath AS Functional Index, BASFI); AS Quality of Life (ASQoL); Back Pain (Nocturnal and Overall) and demographic features were assessed in a subsample (n = 83) (statistical significance defined at P <or= 0.05).
Since disease onset 108/113 patients (96%) reported flares, and 82/99 (83%) reported symptoms of AS between flares. Flares typically lasted days or weeks. When patients were asked to characterize their disease pattern using the Flare Illustration, patterns with constant symptoms predominated (>70% of patients) and patterns with constant symptoms since onset (vs intermittent symptoms) were associated with worse health status (ASQoL: P = 0.007; BASDAI: P = 0.029; BASFI: P = 0.013, overall back pain: P = 0.025).
Almost all AS patients report flares in disease activity: 70-80% report constant symptoms with single/repeated flares, while 20-30% report flares with no intermittent symptoms. The former is associated with a significantly poorer health status. These findings will be validated in a prospective study.
许多强直性脊柱炎（AS）患者报告有疾病活动度较高的时期（病情发作）。这项初步研究旨在记录AS患者报告的疾病活动模式，并研究其与疾病特异性健康状况指标的关联。
连续纳入114例AS患者，询问他们是否经历过病情发作，以及在发作间期是否有AS症状。向他们展示疾病随时间变化的发作示意图，并要求他们选择最能描述其疾病的模式：（i）自症状发作以来；（ii）在过去一年中。在一个子样本（n = 83）中评估报告的疾病模式与疾病活动度（巴斯强直性脊柱炎疾病活动指数，BASDAI）、功能障碍（巴斯强直性脊柱炎功能指数，BASFI）、AS生活质量（ASQoL）、背痛（夜间和总体）以及人口统计学特征之间的关联（统计学显著性定义为P≤0.05）。
自疾病发作以来，108/113例患者（96%）报告有病情发作，82/99例（83%）报告在发作间期有AS症状。发作通常持续数天或数周。当要求患者使用发作示意图描述其疾病模式时，持续有症状的模式占主导（>70%的患者），自发作起就持续有症状（与间歇性症状相比）的模式与较差的健康状况相关（ASQoL：P = 0.007；BASDAI：P = 0.029；BASFI：P = 0.013，总体背痛：P = 0.025）。
几乎所有AS患者都报告有疾病活动发作：70 - 80%报告有单次/反复发作的持续症状，而20 - 30%报告发作时无间歇性症状。前者与明显较差的健康状况相关。这些发现将在前瞻性研究中得到验证。
