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疾病活动度与男性中轴型脊柱关节炎患者 MRI 骶髂关节炎症的纵向相关性:DESIR 队列 2 年研究。

Disease activity is longitudinally related to sacroiliac inflammation on MRI in male patients with axial spondyloarthritis: 2-years of the DESIR cohort.

机构信息

Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands Department of Rheumatology, University Hospital La Paz, IdiPaz, Madrid, Spain.

Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

Ann Rheum Dis. 2016 May;75(5):874-8. doi: 10.1136/annrheumdis-2015-207786. Epub 2015 Sep 24.

Abstract

OBJECTIVES

To investigate the longitudinal relationship between inflammatory lesions in sacroiliac joints on MRI (MRI-SI) and clinical disease activity measures (DA) in patients with axial spondyloarthritis (axSpA).

METHODS

Two-year follow-up data from 167 patients (50% males, mean (SD) age 33 (9) years) fulfilling the Assessment of SpondyloArthritis international Society axSpA criteria in the DEvenir des Spondylarthopathies Indifférenciées Récentes cohort with MRI-SI at baseline, 1 year and 2 years were analysed. The relationship between MRI-SI (as dependent variable) and DA (Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), patient's global DA, night pain, C reactive protein and erythrocyte sedimentation rate, as independent variables) was investigated using two types of generalised estimating equations (GEE) models: model of absolute scores and model of change scores.

RESULTS

In the model of absolute scores, the relationship between DA and MRI-SI was different for males and females: in males, but not in females, a statistically significant relationship with MRI-SI was found for all DA except BASDAI. In the model of changes, only ASDAS (beta (95% CI): 2.79 (0.85 to 4.73) and pain at night (0.97 (0.04 to 1.90)) were significantly associated in males while again in females no significant relationship was found. ASDAS fitted the data best.

CONCLUSIONS

In male patients, but not in female patients, with axSpA, clinical DA, especially if measured by ASDAS, is longitudinally associated with MRI-SI inflammatory lesions.

摘要

目的

研究中轴型脊柱关节炎(axSpA)患者骶髂关节磁共振成像(MRI-SI)炎症病变与临床疾病活动指标(DA)的纵向关系。

方法

对 DEvenir des Spondylarthopathies Indifférenciées Récentes 队列中符合脊柱关节炎国际协会 axSpA 标准的 167 例患者(50%为男性,平均[SD]年龄 33[9]岁)的 2 年随访数据进行分析,这些患者在基线、1 年和 2 年均进行了 MRI-SI 检查。使用两种广义估计方程(GEE)模型(绝对评分模型和变化评分模型)分析 MRI-SI(因变量)与 DA(强直性脊柱炎疾病活动评分(ASDAS)、巴斯强直性脊柱炎疾病活动指数(BASDAI)、患者整体 DA、夜间疼痛、C 反应蛋白和红细胞沉降率,自变量)之间的关系。

结果

在绝对评分模型中,DA 与 MRI-SI 之间的关系在男性和女性中有所不同:在男性中,但在女性中,除 BASDAI 外,所有 DA 与 MRI-SI 均呈统计学显著相关。在变化模型中,只有 ASDAS(β(95%CI):2.79(0.85 至 4.73)和夜间疼痛(0.97(0.04 至 1.90))在男性中与 MRI-SI 显著相关,而在女性中则未发现显著相关性。ASDAS 最适合该数据。

结论

在 axSpA 男性患者中,但不在女性患者中,临床 DA,尤其是通过 ASDAS 测量的 DA,与 MRI-SI 炎症病变呈纵向相关。

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