Division of Rheumatology, Department of Internal Medicine, School of Medicine, The Catholic University of Korea, Seoul St. Mary's Hospital, 222 Banpo-Daero, Seocho-gu, Seoul, 137-040, South Korea.
Division of Rheumatology, Department of Internal Medicine, Armed Forces Capital hospital, Armed Forces Medical Command, Seongnam, South Korea.
BMC Musculoskelet Disord. 2019 Apr 4;20(1):144. doi: 10.1186/s12891-019-2549-5.
This study compared clinical, laboratory and radiographic features of axial spondyloarthritis (axSpA) between ankylosing spondylitis (AS) and non-radiographic axial spondyloarthritis (nrAxSpA) of young male patients. Additionally, we sought factors which can predict the baseline inflammatory status of sacroiliac joint (SIJ) in axSpA.
We retrospectively reviewed the medical records of 322 patients who visited our hospital due to inflammatory back pain, and 159 male patients with axSpA were enrolled. Enrolled patients were divided into two groups, AS group and nrAxSpA group, and medical records, laboratory data, radiologic findings were collected and analyzed.
Alternating buttock pain and CRP elevation were significantly frequent in AS patients than nrAxSpA patients (68.8% vs 41.3%, P = 0.001, 63.5% vs 37.1%, P = 0.002), and SPondyloArthritis Research Consortium of Canada (SPARCC) score of SIJ was higher in AS patients than nrAxSpA patients (14.0 vs 5.0, P < 0.0001). Baseline sacroiliitis severity, psoriasis, and CRP elevation had positive association in univariate and multivariate regression analysis for SIJ inflammatory SPARCC score.
AS patients were more frequently in acute inflammatory state than nrAxSpA patients according to laboratory and MRI finding. Baseline sacroiliitis grade was significantly associated with baseline inflammatory SPARCC score of SIJ. AS patients might need more intense initial treatment to resolve active inflammatory lesion of SIJ and prevent further radiologic progression.
本研究比较了年轻男性强直性脊柱炎（AS）和非放射学中轴型脊柱关节炎（nrAxSpA）患者的临床、实验室和影像学特征。此外，我们还寻找了可以预测中轴型脊柱关节炎（axSpA）骶髂关节（SIJ）基线炎症状态的因素。
我们回顾性分析了因炎症性背痛就诊于我院的 322 例患者的病历资料，其中 159 例男性 axSpA 患者被纳入研究。入组患者分为 AS 组和 nrAxSpA 组，收集并分析了病历资料、实验室数据和影像学结果。
交替性臀部疼痛和 CRP 升高在 AS 患者中明显比 nrAxSpA 患者更常见（68.8%比 41.3%，P=0.001，63.5%比 37.1%，P=0.002），AS 患者的 SIJ SPARCC 评分也高于 nrAxSpA 患者（14.0 比 5.0，P<0.0001）。在单因素和多因素回归分析中，基线骶髂关节炎严重程度、银屑病和 CRP 升高与 SIJ 炎症性 SPARCC 评分呈正相关。
根据实验室和 MRI 检查结果，AS 患者的急性炎症状态比 nrAxSpA 患者更常见。基线骶髂关节炎分级与 SIJ 的基线炎症性 SPARCC 评分显著相关。AS 患者可能需要更强烈的初始治疗来缓解 SIJ 的活动性炎症病灶，并预防进一步的放射学进展。
