Rohde Gudrun, Berg Kari Hansen, Prøven Anne, Haugeberg Glenn
Faculty of Health and Sport Sciences, University of Agder, Kristiansand, 422, 4604, Kristiansand, Norway.
Department of Clinical Research, Sorlandet Hospital, Kristiansand, 4604, Norge.
BMC Musculoskelet Disord. 2017 Aug 1;18(1):328. doi: 10.1186/s12891-017-1693-z.
Axial spondyloarthritis (ax-SpA) is a chronic inflammatory disease of the spine causing pain, stiffness, loss in physical function, and fatigue. Therefore, the physical and psychological burden of having this chronic disease can reduce the quality of life. We aimed to explore the relationship between demographic- and disease-related variables and health-related quality of life (HRQoL) in patients with ax-SpA.
Demographic- and disease-related, HRQoL-related and treatment data were collected. Disease measures included the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the BAS Functional Index (BASFI), the BAS Global (BAS-G) score, the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), the Health Assessment Questionnaire (HAQ) and co-morbidity. HRQoL was assessed using the SF-36 and the utility measures SF-6D and 15D. Variables associated with HRQoL were identified in unadjusted and adjusted analyses.
We examined 380 patients with ax-SpA (67% men) with a mean age of 46 years. Among them, 86% reported exercising >1 h per week. Mean values were as follows: BASDAI, 3.17; MASES, 3.19; BASFI, 2.71; BAS-G. 3.88; and HAQ, 0.56. The percentage of current users of NSAIDs was 44%, and of DMARDs 23%. In multivariate analyses, exercising 1-3 h per week (B = 2.73, p = 0.022) and exercising >3 h per week (B = 2.71, p = 0.020), lower HAQ scores (B = -4.61, p = 0.001), lower BASFI scores (B = -1.05, p = 0.010) and lower BAS-G scores (B = -0.91, p = 0.001) were independently associated with higher SF-36-PCS scores, whereas modest alcohol consumption (B = 4.63, p = 0.018) and a lower BAS-G score (B = -1.73, p < 0.001) were independently associated with higher SF-36-MCS scores. Exercising 1-3 h per week (B = 0.032, p = 0.004) and exercising >3 h per week (B = 0.036, p = 0.001), lower HAQ scores (B = -0.051, p < 0.001), lower BAS-G scores (B = -0.010, p < 0.001) and co-morbidity (B = -0.014, p = 0.004) were independently associated with higher 15D scores. Finally, exercising 1-3 h per week (B = 0.045, p = 0.001) and exercising > 3 h per week (B = 0.053, p < 0.001), lower HAQ scores (B = -0.054, p = 0.001) and lower BAS-G scores (B = -0.020, p < 0.001) were associated with higher SF-6D scores.
In patients with ax-SpA, a low level of physical activity, impaired physical function and impaired general well-being were independently and consistently associated with a decreased HRQoL across all applied measures.
中轴型脊柱关节炎（ax-SpA）是一种脊柱慢性炎症性疾病，可导致疼痛、僵硬、身体功能丧失和疲劳。因此，患这种慢性病带来的身心负担会降低生活质量。我们旨在探讨ax-SpA患者的人口统计学和疾病相关变量与健康相关生活质量（HRQoL）之间的关系。
收集了人口统计学、疾病相关、HRQoL相关和治疗数据。疾病测量指标包括巴斯强直性脊柱炎疾病活动指数（BASDAI）、巴斯功能指数（BASFI）、巴斯综合指数（BAS-G）评分、马斯特里赫特强直性脊柱炎附着点炎评分（MASES）、健康评估问卷（HAQ）和合并症。使用SF-36以及效用测量指标SF-6D和15D评估HRQoL。在未调整和调整分析中确定与HRQoL相关的变量。
我们研究了380例ax-SpA患者（67%为男性），平均年龄46岁。其中，86%的患者报告每周锻炼时间超过1小时。平均值如下：BASDAI为3.17；MASES为3.19；BASFI为2.71；BAS-G为3.88；HAQ为0.56。当前使用非甾体抗炎药的患者比例为44%，使用改善病情抗风湿药的患者比例为23%。在多变量分析中，每周锻炼1 - 3小时（B = 2.73，p = 0.022）和每周锻炼超过3小时（B = 2.71，p = 0.020）、较低的HAQ评分（B = -4.61，p = 0.001）、较低的BASFI评分（B = -1.05，p = 0.010）和较低的BAS-G评分（B = -0.91，p = 0.001）与较高的SF-36身体功能（PCS）评分独立相关，而适量饮酒（B = 4.63，p = 0.018）和较低的BAS-G评分（B = -1.73，p < 0.001）与较高的SF-36精神健康（MCS）评分独立相关。每周锻炼1 - 3小时（B = 0.032，p = 0.004）和每周锻炼超过3小时（B = 0.036，p = 0.001）、较低的HAQ评分（B = -0.051，p < 0.001）、较低的BAS-G评分（B = -0.010，p < 0.001）和合并症（B = -0.014，p = 0.004）与较高 的15D评分独立相关。最后，每周锻炼1 - 3小时（B = 0.045，p = 0.001）和每周锻炼超过3小时（B = 0.053，p < 0.001）、较低的HAQ评分（B = -0.054，p = 0.001）和较低的BAS-G评分（B = -0.020，p < 0.001）与较高的SF-6D评分相关。
在ax-SpA患者中，低水平的身体活动、身体功能受损和总体健康状况受损与所有应用测量指标中HRQoL降低独立且持续相关。
