Jiang Yutong, Yang Mingcan, Wu Husheng, Song Hui, Zhan Feng, Liu Shengyun, Gao Guanmin, Liu Zhangsuo, Hu Zhaoxian, He Peigen, Zhang Shengtao, Hu Zaiying, Lin Zhiming, Zhang Yanli, Li Yinong, Shen Lingxun, Huang Anbing, Liao Zetao, Cao Shuangyan, Wei Yanlin, Li Li, Li Qiuxia, Lv Qing, Qi Jun, Huang Jianlin, Li Tianwang, Jin O, Pan Yunfeng, Gu J
Department of Rheumatology and Immunology, The Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou, 510630, China.
Clin Rheumatol. 2015 Mar;34(3):503-10. doi: 10.1007/s10067-014-2688-x. Epub 2014 Jun 20.
Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is a standard instrument regularly used to assess disease activity of patients with ankylosing spondylitis (AS). However, the well-being of a patient is also affected by impairment of function as well as psychological status and other factors. The objective of this study was to evaluate if psychological status, stressful life events, and sleep quality contribute significantly to BASDAI. Six hundred eighty-three AS patients satisfying the Modified New York Criteria for AS were recruited from the rheumatology clinics of seven hospitals in China. Patients with other concomitant disorders were excluded. Participants were requested to complete a set of clinical examinations and the following questionnaires: Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), Zung Self-Rating Anxiety Scale (SAS), Zung Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index Questionnaire (PSQI), Health Assessment Questionnaire for Spondyloarthropathies (HAQ-S), and Social Readjustment Rating Scale (SRRS). Spearman correlation analysis showed that BASDAI was highly associated with degree and duration of morning stiffness, overall pain, nocturnal back pain, overall back pain, anxiety, and BASFI (all P < 0.001), but were not associated with education, HAQ-S, and sleep medication in PSQI (P > 0.05). Multiple stepwise regression analysis indicated that overall pain was the maximal statistical contribution in predicting disease activity (standardized coefficient, 0.335). In hierarchic multiple regression analysis, psychological variables added an only additional 2.7% to the overall R(2) beyond that accounted for by demographic and medical variables, resulting in a final R(2) of 53.5%. Although BASDAI is a very good measurement of pain and stiffness and to a certain extent effect of functional impairment in AS, it barely takes into account psychological status, stress life events, and sleep quality These factors should be evaluated by other modalities.
巴斯强直性脊柱炎疾病活动指数（BASDAI）是一种常用于评估强直性脊柱炎（AS）患者疾病活动度的标准工具。然而，患者的健康状况还受到功能损害、心理状态及其他因素的影响。本研究的目的是评估心理状态、应激性生活事件和睡眠质量是否对BASDAI有显著影响。从中国七家医院的风湿病门诊招募了683例符合AS改良纽约标准的患者。排除患有其他合并症的患者。参与者被要求完成一系列临床检查以及以下问卷：巴斯强直性脊柱炎疾病活动指数（BASDAI）、巴斯强直性脊柱炎功能指数（BASFI）、zung自评焦虑量表（SAS）、zung自评抑郁量表（SDS）、匹兹堡睡眠质量指数问卷（PSQI）、脊柱关节病健康评估问卷（HAQ-S）和社会再适应评定量表（SRRS）。Spearman相关性分析显示，BASDAI与晨僵程度和持续时间、全身疼痛、夜间背痛、背部整体疼痛、焦虑及BASFI高度相关（均P < 0.001），但与教育程度、HAQ-S及PSQI中的睡眠药物使用情况无关（P > 0.05）。多元逐步回归分析表明，全身疼痛在预测疾病活动度方面具有最大的统计学贡献（标准化系数，0.335）。在分层多元回归分析中，心理变量在人口统计学和医学变量所解释的总R²基础上仅额外增加了2.7%，最终R²为53.5%。虽然BASDAI是AS疼痛和僵硬以及功能损害影响的良好测量指标，但它几乎没有考虑心理状态、应激性生活事件和睡眠质量。这些因素应通过其他方式进行评估。
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