Wang Yu, Lian Fan, Li Jia-ping, Chen Wei, Yang Xiu-yan, Yang Nian-sheng, Yang Jian-yong, Meng Quan-fei
Department of Interventional Radiology, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
Zhonghua Yi Xue Za Zhi. 2011 Apr 19;91(15):1022-5.
To analyze the relationship between the radiological progression and quality of life in ankylosing spondylitis (AS) patients using etanercept/methotrexate (MTX) combination therapy.
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.
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.
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.
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。
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。
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。
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。