Disciplina de Reumatologia, Universidade de São Paulo, Brazil.
Clin Exp Rheumatol. 2013 Jul-Aug;31(4):484-9. Epub 2013 Jul 29.
This study analysed the frequency of anterior uveitis (AU) and its correlations in a large cohort of patients with spondyloarthritis (SpA).
A common protocol of investigation was prospectively applied to 2012 SpA patients in 85 centres from 10 Ibero-American countries. Clinical and demographic variables and disease indexes were investigated. Categorical variables were compared by χ2 and Fisher's exact test, and continuous variables were compared by ANOVA or Kruskal-Wallis test. A value of p<0.05 was considered significant.
AU was referred by 372 SpA patients (18.5%). AU was statistically associated with inflammatory low back pain (p<0.001), radiographic sacroiliitis (p<0.001), enthesopathies (p=0.004), urethritis/acute diarrhoea (p<0.001), balanitis (p=0.002), hip involvement (p=0.002), HLA-B27 (p=0.003), and higher C-reactive protein (p=0.001), whilst it was negatively associated with the number of painful (p=0.03) and swollen (p=0.005) peripheral joints, psoriatic arthritis (p<0.001), psoriasis (p<0.001), nail involvement (p<0.001), and dactilitis (p=0.062; trend). No association with gender, race, and indices (disease activity, functionality and quality of life) was observed. Logistic regression showed that ankylosing spondylitis (p=0.001) and HLA-B27 (p=0.083; trend) was significantly associated with AU, while extra-articular manifestations (predominantly psoriasis) were negatively associated (p=0.016).
Anterior uveitis is a frequent extra-articular manifestation in SpA patients, positively associated with axial involvement and HLA-B27 and negatively associated with peripheral involvement and psoriatic arthritis.
本研究分析了在一个大型脊柱关节炎(SpA)患者队列中前葡萄膜炎(AU)的频率及其相关性。
对来自 10 个伊比利亚美洲国家的 85 个中心的 2012 名 SpA 患者前瞻性应用了一项通用研究方案。调查了临床和人口统计学变量以及疾病指标。通过 χ2 和 Fisher 确切检验比较分类变量,通过 ANOVA 或 Kruskal-Wallis 检验比较连续变量。p 值<0.05 被认为具有统计学意义。
372 名 SpA 患者(18.5%)报告有 AU。AU 与炎症性腰痛(p<0.001)、放射影像学骶髂关节炎(p<0.001)、肌腱端病(p=0.004)、尿道炎/急性腹泻(p<0.001)、龟头炎(p=0.002)、髋关节受累(p=0.002)、HLA-B27(p=0.003)以及更高的 C 反应蛋白(p=0.001)呈统计学相关,而与疼痛(p=0.03)和肿胀(p=0.005)关节数量呈负相关,与银屑病关节炎(p<0.001)、银屑病(p<0.001)、甲病(p<0.001)和指炎(p=0.062;趋势)呈负相关。未观察到性别、种族和指数(疾病活动度、功能和生活质量)与 AU 之间存在关联。Logistic 回归显示强直性脊柱炎(p=0.001)和 HLA-B27(p=0.083;趋势)与 AU 显著相关,而关节外表现(主要为银屑病)呈负相关(p=0.016)。
前葡萄膜炎是 SpA 患者常见的关节外表现,与轴性受累和 HLA-B27 呈正相关,与外周受累和银屑病关节炎呈负相关。