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[采用BASDAI和ASDAS方法对强直性脊柱炎疾病活动度进行评分]

[Scoring of disease activity using BASDAI and ASDAS method in ankylosing spondylitis].

作者信息

Bobek Dubravka, Zagar Iva, Kovač-Durmiš Kristina, Perić Porin, Ćurković Božidar, Babić-Naglić Ðurđica

出版信息

Reumatizam. 2012;59(1):5-10.

Abstract

Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) is the most frequently used ankylosing spondylitis activity assesment by which through 6 questions 5 basic diseases symptoms (fatigue, back pain, joint pain/swelling, enthesitic points, intensity and duration of morning stiffness) are being evaluated. In distinction from mentioned, Ankylosing Spondylitis Disease Activity Score (ASDAS) is the first validated index for the AS activity assessment with the patient's assessments of the disease symptoms (back pain, duration of the morning stiffess, activity of the disease, pains and swelling of the peripheral joints) includes the acute phase reactants (SE or CRP). We compared BASDAI and ASDAS indexes to the group of patients with the AS, in order to evaluate their congruence and to evaluate the inluence of SE, fatigue and back pain at obtained values. The cross-sectional study was performed in a group of 36 patients with the AS whose disease activity levels were evaluated by the BASDAI and ASDAS (SE) index. Statistical data analysis was performed by Student t-test and frequency tables for non-parameter data. As it has been expected the significant correlation between BASDAI and ASDAS indexes has been confirmed (r=0.796; p=0.00). BASDAI/ASDAS average value of all of the patients was 4.2/2.8. From 36 patients with the AS according to the BASDAI index 42% had mild active disease (BASDAI <4), while according to ASDAS index 44% patients had very active disease (ASDAS 2.1-.5.3). Higher activity of the disease according to ASDAS index is the result of the elevated sedimentation which is assessed only in ASDAS index. Patients with higher BASDAI index statistically have more significantly expressed fatigue and spinal pain without statistically significant difference in sedimentation (p=0.120). Examinees with higher ASDAS index have also significantly more expressed fatigue and back pain, but unlike BASDAI they have sedimentation (p=0.001). ASDAS is more recent clinical indicator of the AS activities which could be compared to BASDAI instrument. In this group of patients ASDAS seems to be more sensitive index because it discriminates more patients with the active disease.

摘要

巴斯强直性脊柱炎疾病活动指数(BASDAI)是最常用的强直性脊柱炎活动评估指标,通过6个问题对5种基本疾病症状(疲劳、背痛、关节疼痛/肿胀、附着点炎、晨僵强度和持续时间)进行评估。与上述指标不同的是,强直性脊柱炎疾病活动评分(ASDAS)是首个经过验证的用于评估强直性脊柱炎活动的指标,它将患者对疾病症状(背痛、晨僵持续时间、疾病活动度、外周关节疼痛和肿胀)的评估与急性期反应物(血沉或C反应蛋白)相结合。我们将BASDAI和ASDAS指标应用于强直性脊柱炎患者群体,以评估它们的一致性,并评估血沉、疲劳和背痛对所得值的影响。对36例强直性脊柱炎患者进行了横断面研究,通过BASDAI和ASDAS(血沉)指标评估其疾病活动水平。采用学生t检验和非参数数据频率表进行统计数据分析。正如预期的那样,BASDAI和ASDAS指标之间存在显著相关性(r = 0.796;p = 0.00)。所有患者的BASDAI/ASDAS平均值为4.2/2.8。在36例强直性脊柱炎患者中,根据BASDAI指标,42%的患者患有轻度活动性疾病(BASDAI <4),而根据ASDAS指标,44%的患者患有非常活动性疾病(ASDAS 2.1 - 5.3)。根据ASDAS指标,疾病活动度较高是血沉升高的结果,而血沉仅在ASDAS指标中进行评估。BASDAI指标较高的患者在统计学上疲劳和脊柱疼痛表现更明显,血沉无统计学显著差异(p = 0.120)。ASDAS指标较高的受试者疲劳和背痛也更明显,但与BASDAI不同的是,他们有血沉升高(p = 0.001)。ASDAS是强直性脊柱炎活动度更新的临床指标,可与BASDAI工具进行比较。在这组患者中,ASDAS似乎是更敏感的指标,因为它能区分出更多活动性疾病患者。

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