Department of Medicine, Division of Rheumatology, Maastricht University Medical Center, The Netherlands.
Ann Rheum Dis. 2012 Apr;71(4):518-23. doi: 10.1136/annrheumdis-2011-200411. Epub 2011 Oct 11.
Structural damage of the spine in ankylosing spondylitis (AS) is associated with worse physical function and impaired spinal mobility. Knowledge about predictors of new syndesmophyte formation is limited.
To assess the development of new syndesmophytes at the level of individual vertebral bodies and to assess predictors for this development.
Clinical and radiological data from 132 patients from the Outcome in Ankylosing Spondylitis International Study for whom complete sets of radiographs were available at baseline and at 2- and 4-year follow-up were used. Univariable and multivariable logistic regression analyses were performed to identify predictors associated with development of new syndesmophytes within 4 years.
At baseline, 81 (61%) patients had syndesmophytes. New syndesmophytes developed in 44 (33%) patients within 2 years and in 63 (48%) patients within 4 years. The RR of developing new syndesmophytes was 5.0 (95% CI 2.5 to 10.2) at 4 years in patients with existing syndesmophytes as compared with patients without. In the univariable analysis, older age, worse functional status, male gender, erythrocyte sedimentation rate and existing syndesmophytes were associated with development of new syndesmophytes at 4 years. In the multivariable logistic regression analysis, only the presence of existing syndesmophytes was a significant predictor (OR 18.72, 95% CI 6.44 to 54.42). When existing syndesmophytes were taken out from the model, age (OR 1.07, 95% CI 1.03 to 1.11) and male gender (OR 3.98, 95% CI 1.47 to 10.77) were statistically significant contributors.
In AS, patients with existing syndesmophytes are prone to develop new syndesmophytes over time.
强直性脊柱炎（AS）脊柱结构损伤与较差的身体功能和受损的脊柱活动度有关。关于新骨桥形成的预测因素知之甚少。
评估个体椎体水平新骨桥形成的发展情况，并评估其发展的预测因素。
使用来自强直性脊柱炎国际研究结果研究的 132 名患者的临床和放射学数据，这些患者在基线时以及 2 年和 4 年随访时均有完整的放射照片。进行单变量和多变量逻辑回归分析，以确定与 4 年内新骨桥形成相关的预测因素。
基线时，81 名（61%）患者有骨桥。44 名（33%）患者在 2 年内出现新骨桥，63 名（48%）患者在 4 年内出现新骨桥。与无骨桥患者相比，基线时存在骨桥的患者在 4 年内出现新骨桥的 RR 为 5.0（95%CI 2.5 至 10.2）。单变量分析中，年龄较大、功能状态较差、男性、红细胞沉降率和现有骨桥与 4 年内出现新骨桥有关。在多变量逻辑回归分析中，只有现有的骨桥是一个显著的预测因素（OR 18.72，95%CI 6.44 至 54.42）。当从模型中去除现有的骨桥时，年龄（OR 1.07，95%CI 1.03 至 1.11）和男性（OR 3.98，95%CI 1.47 至 10.77）是统计学上显著的因素。
在 AS 中，随着时间的推移，存在骨桥的患者容易出现新的骨桥形成。
