Landewé R, Dougados M, Mielants H, van der Tempel H, van der Heijde D
Department of Internal Medicine, Maastricht University Medical Centre, The Netherlands.
Ann Rheum Dis. 2009 Jun;68(6):863-7. doi: 10.1136/ard.2008.091793. Epub 2008 Jul 15.
To study the relationship between disease activity, radiographic damage and physical function in patients with ankylosing spondylitis (AS) PATIENTS AND METHODS: Baseline and 2-year data of the Outcome in Ankylosing Spondylitis International Study (OASIS)(217 patients) were used. Physical function was expressed by the Bath Ankylosing Spondylitis Functional Index (BASFI) and the Dougados Functional Index (DFI); disease activity by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and by erythrocyte sedimentation rate and C-reactive protein; and structural damage by the modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Syndesmophyte- and non-syndesmophyte sum cores, and numbers of affected (bridged) vertebral units were derived from the mSASSS. Univariate correlations were calculated on baseline values using the Spearman rank correlation. Multivariate associations were investigated by generalised estimating equations (GEE) on baseline and 2-year data.
mSASSS correlated moderately well with BASFI (Spearman's r = 0.45) and DFI (r = 0.38). BASDAI correlated well with BASFI (r = 0.66) and DFI (r = 0.59). Correlation coefficients for mSASSS versus BASFI and DFI decreased by increasing levels of BASDAI, being zero at the highest quintile of BASDAI. GEE showed that both BASDAI and mSASSS independently and significantly helped to explain either BASFI or DFI. Results were similar for syndesmophyte sum score, non-syndesmophyte sum score, number of affected VUs or number of VUs with bridging. The lumbar part of the mSASSS contributed similarly to the cervical part in explaining BASFI/DFI.
Physical function impairment in AS is independently caused by patient-reported disease activity and the level of structural damage of the lumbar and cervical spine. Syndesmophytes and other radiographic abnormalities contribute to physical function impairment.
研究强直性脊柱炎（AS）患者的疾病活动度、影像学损伤与身体功能之间的关系。
采用强直性脊柱炎国际研究（OASIS）的基线数据和2年数据（217例患者）。身体功能通过巴斯强直性脊柱炎功能指数（BASFI）和杜加多斯功能指数（DFI）表示；疾病活动度通过巴斯强直性脊柱炎疾病活动指数（BASDAI）以及红细胞沉降率和C反应蛋白表示；结构损伤通过改良斯托克强直性脊柱炎脊柱评分（mSASSS）表示。从mSASSS得出韧带骨赘和非韧带骨赘总和评分以及受累（相连）椎体单元数量。使用Spearman等级相关性对基线值进行单变量相关性计算。通过广义估计方程（GEE）对基线数据和2年数据进行多变量关联研究。
mSASSS与BASFI（Spearman氏r = 0.45）和DFI（r = 0.38）中度相关。BASDAI与BASFI（r = 0.66）和DFI（r = 0.59）高度相关。随着BASDAI水平升高，mSASSS与BASFI和DFI的相关系数降低，在BASDAI最高五分位数时为零。GEE显示，BASDAI和mSASSS均独立且显著有助于解释BASFI或DFI。韧带骨赘总和评分、非韧带骨赘总和评分、受累椎体单元数量或相连椎体单元数量的结果相似。在解释BASFI/DFI方面，mSASSS的腰椎部分与颈椎部分贡献相似。
AS患者的身体功能损害由患者报告的疾病活动度以及腰椎和颈椎的结构损伤程度独立引起。韧带骨赘和其他影像学异常导致身体功能损害。
