Department of Medicine.
J Clin Rheumatol. 2019 Jan;25(1):16-23. doi: 10.1097/RHU.0000000000000750.
This study aimed to identify factors associated with EuroQoL-5 Dimensions, 5 Levels and Patient Acceptable Symptom State (PASS) and health utility (HU) in Thai patients with ankylosing spondylitis (AS).
This was a cross-sectional study of consecutive AS patients visiting Siriraj Hospital between May 31, 2012, and March 31, 2016. Demographic data and outcomes related to HU (Thai version of EuroQoL-5 Dimensions, 5 Levels), disease activity (Bath Ankylosing Spondylitis Disease Activity Index, Ankylosing Spondylitis Disease Activity Score-erythrocyte sedimentation rate or Ankylosing Spondylitis Disease Activity Score-C-reactive protein, number of tender and swollen joints, and enthesitis), and functional status (Bath Ankylosing Spondylitis Functional Index and Health Assessment Questionnaire) were collected. Regression analysis was used to explore factors associated with each EuroQOL-5 Dimensions (EQ-5D) domain, HU, and PASS.
Among 119 AS patients, the mean age was 40.4 years; 61.3% were male. The mean EQ-5D was 0.75. In univariate analysis, lower disease activity and less impaired function were significantly associated with higher HU and not to mild problems in each EQ-5D domain. In multivariate regression analysis, Bath Ankylosing Spondylitis Disease Activity Index, C-reactive protein, and Health Assessment Questionnaire adjusting for age explained 77.4% of the HU variance. Patients answering yes to PASS were significantly older, had higher HU, and lower disease activity compared with those answering no to PASS. Usual activity and pain problems were importantly related to PASS after adjusting for other domains and age.
Disease activity and functional status in AS patients were significant factors related to HU and PASS. To improve quality of life, treatment goals should be achieving remission, improving function, and controlling pain.
本研究旨在确定与泰国强直性脊柱炎（AS）患者的 EuroQoL-5 维度、5 个等级和可接受症状状态（PASS）以及健康效用（HU）相关的因素。
这是一项横断面研究，纳入了 2012 年 5 月 31 日至 2016 年 3 月 31 日期间在 Siriraj 医院就诊的连续 AS 患者。收集了人口统计学数据和与 HU（泰国版 EuroQoL-5 维度，5 个等级）、疾病活动度（Bath 强直性脊柱炎疾病活动指数、红细胞沉降率或 C 反应蛋白的强直性脊柱炎疾病活动评分、压痛和肿胀关节数、肌腱附着点炎）和功能状态（Bath 强直性脊柱炎功能指数和健康评估问卷）相关的结果。回归分析用于探讨与每个 EuroQOL-5 维度（EQ-5D）域、HU 和 PASS 相关的因素。
在 119 例 AS 患者中，平均年龄为 40.4 岁，61.3%为男性。平均 EQ-5D 为 0.75。在单因素分析中，较低的疾病活动度和较少的功能障碍与较高的 HU 以及每个 EQ-5D 域的轻度问题无关。在多变量回归分析中，调整年龄后，Bath 强直性脊柱炎疾病活动指数、C 反应蛋白和健康评估问卷解释了 HU 变异的 77.4%。与 PASS 回答否的患者相比，回答是的患者年龄较大，HU 较高，疾病活动度较低。调整其他域和年龄后，日常活动和疼痛问题与 PASS 显著相关。
AS 患者的疾病活动度和功能状态是与 HU 和 PASS 相关的重要因素。为了提高生活质量，治疗目标应该是达到缓解、改善功能和控制疼痛。
