Section of Rheumatology, Rush University Medical Center, Chicago, IL, USA.
Clin Rheumatol. 2009 Oct;28(10):1199-205. doi: 10.1007/s10067-009-1227-7. Epub 2009 Jul 18.
This study focuses on describing full spectrum of clinical, laboratory, and radiological characterization of ankylosing spondylitis (AS) patients in India. Data on 70 consecutive AS patients, seen at the rheumatology clinic in India, was prospectively obtained using investigator-administered questionnaires. Diagnosis was made according to the modified New York criteria. The core set of variables selected by Assessment in AS International society were obtained. The differences in clinical characteristics based on presence or absence of peripheral arthritis, gender, and juvenile (JOAS) vs. adult onset AS (AOAS) were evaluated. The male/female ratio was 5:1. The mean age of onset of symptoms and diagnosis were 23.6 and 32.5 years, respectively. Females had similar spinal indices and radiological damage as male counterpart. However, they had more common extra-articular manifestations and root joint involvement. The majority of patients consisted of AOAS (78.5%) and was clinically similar to JOAS. One or more peripheral joints were involved in 65.7% of patients, affecting predominantly the lower extremity (90.6%, knee 47.1%, and ankle 35.7%) in asymmetrical pattern (78%). Patients with peripheral arthritis had higher erythrocyte sedimentation rate, more frequent enthesitis, root joint, and whole spine involvement, suggesting more aggressive disease. Most common site of enthesitis was chondro-sternal junction (30%) and Achilles tendonitis (24.3%). The root joints frequently involved extra-axial joints. Uveitis was the most common extra-articular manifestation (25.7%). The predominant initial symptom was typical inflammatory low back pain (87.1%). Assessment in ankylosing spondylitis indices showed a moderately severe disease activity and damage with following values: mean Bath Ankylosing Spondylitis Disease Activity Index, 3.2 (+/-1.8); mean Bath Ankylosing Spondylitis Functional Index, 2.3 (+/-2.0); and mean Bath Ankylosing Spondylitis Metrology Index, 3.15 (+/-2.3). Majority of the patients had bilateral sacroiliitis (grades 2-4) on radiographs (87.1%). In conclusion, the features of AS in Indian patients were broadly similar to other part of world, with the exception of increased frequency of peripheral arthritis.
这项研究侧重于描述印度强直性脊柱炎 (AS) 患者的临床、实验室和影像学表现全貌。从印度风湿病诊所前瞻性获得了 70 例连续 AS 患者的数据，使用研究者管理的问卷进行。根据改良的纽约标准进行诊断。获得了评估 AS 国际协会选择的核心变量集。评估了外周关节炎、性别、幼年型（JOAS）与成人发病型（AOAS）的存在与否对临床特征的影响。男性/女性比例为 5:1。症状和诊断的平均发病年龄分别为 23.6 岁和 32.5 岁。女性与男性相比，脊柱指数和影像学损害相似。然而，她们更常见关节外表现和根关节受累。大多数患者为 AOAS（78.5%），与 JOAS 临床相似。1 个或多个外周关节受累见于 65.7%的患者，以下肢（90.6%，膝关节 47.1%，踝关节 35.7%）为主要累及部位，呈不对称性分布（78%）。外周关节炎患者的红细胞沉降率较高，附着点炎、根关节和整个脊柱受累更为频繁，提示疾病更具侵袭性。附着点炎最常见的部位是软骨胸骨结合部（30%）和跟腱炎（24.3%）。根关节常累及颅外关节。葡萄膜炎是最常见的关节外表现（25.7%）。最常见的初始症状是典型的炎症性腰痛（87.1%）。强直性脊柱炎评估指数显示，疾病活动度和损害程度中等严重，以下值为例：平均巴斯强直性脊柱炎疾病活动指数为 3.2（+/-1.8）；平均巴斯强直性脊柱炎功能指数为 2.3（+/-2.0）；平均巴斯强直性脊柱炎计量学指数为 3.15（+/-2.3）。大多数患者的骶髂关节 X 线片均显示双侧（87.1%）骶髂关节炎（2-4 级）。总之，印度患者的 AS 特征与世界其他地区基本相似，除了外周关节炎的发生率较高。
