Centre Hospitalier Universitaire de Besançon and Université de Franche-Comté, Besançon, France.
Arthritis Care Res (Hoboken). 2012 Jul;64(7):1089-93. doi: 10.1002/acr.21648.
To determine the prevalence of uveitis in patients with recent inflammatory back pain (IBP) suggestive of spondylarthritis (SpA), and to investigate the impact of uveitis on the overall features of these patients.
The Devenir des Spondylarthropathies Indifférenciées Récentes (DESIR; Outcome of Recent Undifferentiated Spondylarthropathies) cohort is a prospective multicenter French cohort of 708 patients with early IBP suggestive of SpA. Uveitis was defined by an ophthalmologic episode diagnosed as uveitis by an ophthalmologist, or history of a medical diagnosis of uveitis given to the patient. Data on the baseline demographic characteristics, functional status and quality of life, imaging features, bone mineral density (BMD), and blood tests were compared in patients with and without uveitis. Factors associated with the presence of uveitis were identified both by univariate and multivariate analysis (logistic regression).
The prevalence of uveitis at inclusion in the DESIR cohort was 8.5%. Uveitis occurred after the first symptoms of IBP in 45% of patients. The presence of uveitis was significantly associated (univariate) with pain in the cervical spine, infection preceding inflammatory disease, a previous diagnosis of inflammatory bowel disease (IBD), the Short Form 36 (SF-36; mental and physical health and social relationship subscales), Achilles enthesitis, elevated leukocyte count, and radiologic hip involvement, but not with fulfillment of classification criteria, HLA-B27, Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Disease Activity Score, and BMD. Stepwise multivariate analysis found an association between uveitis and pain in the cervical spine, infection preceding inflammatory disease, a previous diagnosis of IBD, and the physical health limitation of the SF-36 (P < 0.05).
In recent IBP suggestive of SpA, uveitis is associated with IBD and infection. This might suggest a role of environmental factors in the incidence of uveitis in SpA.
确定近期出现炎症性背痛（IBP）且疑似脊柱关节炎（SpA）的患者中葡萄膜炎的患病率，并探讨葡萄膜炎对这些患者整体特征的影响。
Devenir des Spondylarthropathies Indifférenciées Récentes（DESIR；近期未分化脊柱关节炎的转归）队列是一项前瞻性、多中心的法国队列研究，共纳入 708 例早期出现疑似 SpA 的 IBP 患者。葡萄膜炎由眼科医生诊断的葡萄膜炎发作或患者既往诊断的葡萄膜炎病史定义。比较有无葡萄膜炎的患者在基线人口统计学特征、功能状态和生活质量、影像学特征、骨密度（BMD）和血液检查方面的数据。通过单变量和多变量分析（logistic 回归）确定与葡萄膜炎存在相关的因素。
在 DESIR 队列中，葡萄膜炎的患病率为 8.5%。葡萄膜炎发生在 IBP 首发症状后 45%的患者中。葡萄膜炎的存在与颈椎疼痛（单变量）、疾病前感染、既往炎症性肠病（IBD）诊断、简明健康调查问卷 36 项（SF-36；心理健康和生理健康以及社会关系子量表）、跟腱附着点炎、白细胞计数升高和髋关节放射学受累显著相关，但与分类标准、HLA-B27、Bath 强直性脊柱炎疾病活动指数（Bath Ankylosing Spondylitis Disease Activity Index，BASDAI）、Bath 强直性脊柱炎功能指数（Bath Ankylosing Spondylitis Functional Index，BASFI）、强直性脊柱炎疾病活动评分（Ankylosing Spondylitis Disease Activity Score，ASDAS）和 BMD 无关。逐步多变量分析发现，葡萄膜炎与颈椎疼痛、疾病前感染、既往 IBD 诊断以及 SF-36 的生理健康受限相关（P<0.05）。
在近期出现疑似 SpA 的 IBP 患者中，葡萄膜炎与 IBD 和感染相关。这可能提示环境因素在 SpA 患者葡萄膜炎发病中的作用。
