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[使用依那西普/甲氨蝶呤联合疗法的强直性脊柱炎患者的放射学进展及生活质量分析]

[Radiological progression and life quality analysis in ankylosing spondylitis patients using etanercept/methotrexate combination therapy].

作者信息

Wang Yu, Lian Fan, Li Jia-ping, Chen Wei, Yang Xiu-yan, Yang Nian-sheng, Yang Jian-yong, Meng Quan-fei

机构信息

Department of Interventional Radiology, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2011 Apr 19;91(15):1022-5.

Abstract

OBJECTIVE

To analyze the relationship between the radiological progression and quality of life in ankylosing spondylitis (AS) patients using etanercept/methotrexate (MTX) combination therapy.

METHODS

A total of 153 AS cases fulfilling the 1984 modified New York diagnostic criteria were reviewed. All patients received radiological evolution at baseline and during a follow-up period. Radiological progression, clinical remission and life quality were recorded and analyzed for their relations.

RESULTS

The radiological assessments of mSASSS (modified Stoke ankylosing spondylitis spine score) were recorded at baseline, 3, 6 & 12 months after treatment. Life quality assessments were recorded with SF (short-form)-36 simultaneously. No significant radiological improvement was observed at the end points. However, most patients reported a significant improvement of life quality after a combination therapy of etanercept/MTX. BASDAI (Bath ankylosing spondylitis disease activity index), C-reactive protein and erythrocyte sedimentation rate demonstrated similar trends. With no relevance with mSASSS, life quality was significantly correlated with disease activity and pain control.

CONCLUSION

The combination therapy of etanercept/MTX greatly improves life quality in AS patients. Yet clinical remission and pain control offer no hint of a suspension of radiological progression. Routine radiological assessment is required throughout the follow-up period of AS even if life quality index reaches a high level.

摘要

目的

分析使用依那西普/甲氨蝶呤(MTX)联合治疗的强直性脊柱炎(AS)患者的影像学进展与生活质量之间的关系。

方法

回顾了153例符合1984年修订的纽约诊断标准的AS病例。所有患者在基线期和随访期间均接受影像学评估。记录并分析影像学进展、临床缓解情况及生活质量之间的关系。

结果

在治疗后3、6和12个月以及基线期记录改良斯托克强直性脊柱炎脊柱评分(mSASSS)的影像学评估结果。同时使用简明健康状况调查量表(SF-36)记录生活质量评估结果。在终点时未观察到明显的影像学改善。然而,大多数患者在接受依那西普/MTX联合治疗后报告生活质量有显著改善。巴斯强直性脊柱炎疾病活动指数(BASDAI)、C反应蛋白和红细胞沉降率呈现相似趋势。生活质量与mSASSS无关,但与疾病活动度和疼痛控制显著相关。

结论

依那西普/MTX联合治疗可显著改善AS患者的生活质量。然而,临床缓解和疼痛控制并未提示影像学进展停止。即使生活质量指数达到较高水平,在AS的整个随访期间仍需进行常规影像学评估。

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