Yesmin Sabrina, Abdal Syed Jamil, Rahman Aminur, Islam Md Nazrul, Ahammad Alamgir Mustak, Ahmed Shamim, Shahin Md Abu, Chowdhury Minhaj Rahim, Haq Syed Atiqul
Dr. Sirajul Islam Medical College, Dhaka, Bangladesh.
Green Life Center for Rheumatic Care & Research, Dhaka, Bangladesh.
Int J Rheum Dis. 2018 May;21(5):937-942. doi: 10.1111/1756-185X.13263. Epub 2018 Jan 18.
Inflammatory back pain (IBP) is the earliest symptom of axial and other forms of spondyloarthritis (SpA). However, there are no published data on prevalence of IBP among patients suffering from chronic low back pain (CLBP) in Bangladesh. In this study, we estimated the prevalence of IBP and the subtypes of SpA in a tertiary hospital in Bangladesh.
This 1 year cross-sectional study was conducted among 240 CLBP patients in a rheumatology outpatient clinic. Assessment of Spondyloarthritis International Society classification criteria of IBP and predefined recognized classification criteria were followed to define different subtypes of SpA. Means and standard deviations were reported for continuous variables. Descriptive and bi-variate analyses were accordingly performed.
Of 240 CLBP patients, 60 (25%) had IBP and 180 (75%) had mechanical back pain (MBP). Among the 60 IBP patients, 52 (86.6%) had predominantly axial SpA (axSpA) and eight (13.4%) had predominantly peripheral spondyloarthritis. In the axSpA group, 49 (94.2%) had radiographic axSpA (rd-axSpA) also known as AS and three (5.8%) had non-radiographic axSpA (nr-axspA). AxSpA patients could be divided into eight (15.35%) with psoriasis, two (3.8%) with reactive arthritis and one patient (1.9%) had arthritis associated with inflammatory bowel disease. Fifty (83.3%) IBP and 73 (40.6%) MBP patients had age at onset of back pain < 40 years. Forty-two (70%) of the IBP and 100 (55.6%) of the MBP patients had normal body mass index. All these differences were statistically significant (P ≤ 0.0001).
Inflammatory back pain is common among patients presenting with CLBP. The commonest cause of IBP is AS, followed by PsA and nr-axSpA.
炎性腰背痛（IBP）是轴性及其他形式脊柱关节炎（SpA）的最早症状。然而，关于孟加拉国慢性下腰痛（CLBP）患者中IBP患病率尚无公开数据。在本研究中，我们估计了孟加拉国一家三级医院中IBP的患病率及SpA的亚型。
本为期1年的横断面研究在一家风湿病门诊的240例CLBP患者中进行。遵循国际脊柱关节炎协会炎性腰背痛分类标准及预定义的公认分类标准来定义SpA的不同亚型。连续变量报告均值和标准差。相应地进行描述性和双变量分析。
240例CLBP患者中，60例（25%）有IBP，180例（75%）有机械性腰背痛（MBP）。在60例IBP患者中，52例（86.6%）主要为轴性SpA（axSpA），8例（13.4%）主要为外周型脊柱关节炎。在axSpA组中，49例（94.2%）有放射学轴性SpA（rd - axSpA），也称为强直性脊柱炎（AS），3例（5.8%）有非放射学轴性SpA（nr - axspA）。AxSpA患者可分为8例（15.35%）有银屑病，2例（3.8%）有反应性关节炎，1例（1.9%）有关节炎合并炎性肠病。50例（83.3%）IBP患者和73例（40.6%）MBP患者腰背痛起病年龄<40岁。42例（70%）IBP患者和100例（55.6%）MBP患者体重指数正常。所有这些差异均具有统计学意义（P≤0.0001）。
炎性腰背痛在CLBP患者中很常见。IBP最常见的病因是AS，其次是银屑病关节炎（PsA）和非放射学轴性SpA（nr - axSpA）。
