Roberts W N, Larson M G, Liang M H, Harrison R A, Barefoot J, Clarke A K
Royal National Hospital for Rheumatic Diseases, Bath, England.
Br J Rheumatol. 1989 Feb;28(1):40-5. doi: 10.1093/rheumatology/28.1.40.
To determine whether anthropometric techniques widely used for assessment of ankylosing spondylitis (AS) would be useful outcome measures in long-term clinical trials, 52 AS patients at the Royal National Hospital for Rheumatic Diseases were studied. All patients had well documented AS with a mean age of 38.1 years, and had been diagnosed for an average of 7.6 years. Measurements were taken before (B) and after (A) 3-week intensive inpatient physical therapy (PT). Short-term therapeutic effects (over 3 weeks) were significant (adjusted p less than 0.0001) for all five measures tested (chest expansion, finger-to-floor distance, height, lumbar flexion, and cervical rotation). Height (adjusted p less than 0.0001), finger-to-floor distance (adjusted p = 0.047) and cervical rotation (adjusted p = 0.012) diminished over the course of follow-up. Therefore, 3 weeks of hospitalization with intensive physical therapy produces measurable short-term change; minute but measurable change with treatment occurs even in long-standing AS; and detectable changes in physical measurements occur over a 5-year period even in long-standing AS. Anthropometric measurements are useful outcome variables for long-term clinical trials in AS, but the potential for improvement in clinical measurements in long-standing AS is predictably small.
为了确定广泛用于评估强直性脊柱炎（AS）的人体测量技术在长期临床试验中是否会成为有用的疗效指标，我们对皇家国立风湿病医院的52例AS患者进行了研究。所有患者均有详尽记录的AS，平均年龄38.1岁，平均确诊时间7.6年。在为期3周的强化住院物理治疗（PT）之前（B）和之后（A）进行测量。对于所测试的所有五项指标（胸廓活动度、指尖距地距离、身高、腰椎前屈和颈椎旋转），短期治疗效果（超过3周）均显著（校正p值小于0.0001）。在随访过程中，身高（校正p值小于0.0001）、指尖距地距离（校正p值 = 0.047）和颈椎旋转（校正p值 = 0.012）均有所减小。因此，3周的强化住院物理治疗可产生可测量的短期变化；即使在病程较长的AS患者中，治疗也会产生微小但可测量的变化；即使在病程较长的AS患者中，在5年期间身体测量也会出现可检测到的变化。人体测量指标是AS长期临床试验中有用的疗效变量，但可以预见，病程较长的AS患者临床测量指标改善的潜力较小。
