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美国某一学术中心的脊柱关节病患者前葡萄膜炎:一项回顾性研究。

Anterior uveitis in patients with spondyloarthropathies in a single US academic center: a retrospective study.

机构信息

Divison of Rheumatology, Rush University Medical Center, 1161 West Harrison Street, Suite 510, Chicago, IL, 60612, USA.

Ophthalmology Department, Rush University Medical Center, 1725 W Harrison St, Chicago, IL, 60612, USA.

出版信息

Rheumatol Int. 2019 Sep;39(9):1607-1614. doi: 10.1007/s00296-019-04386-6. Epub 2019 Jul 24.

Abstract

Uveitis may represent an opportunity to diagnose spondyloarthropathies (SpA) earlier and influence treatment decisions. We describe the percentage of acute anterior uveitis (AAU) in a diverse group of SpA patients seen at one academic setting and compare demographic and clinical characteristics according to the presence of uveitis. We conducted a retrospective study of patients with SpA and AAU (January 2016-June 2017). Patients were identified using ICD-10 and administrative claim codes, diagnoses were confirmed through chart review. Extracted data included demographics, laboratory, clinical data, treatment and Routine Assessment of Patient Index Data 3 (RAPID3) scores based on Multidimensional Health Assessment Questionnaire (MDHAQ). Baseline description and comparison between the two groups were performed. We included 190 patients, mostly men (59.5%), with a mean age of 45.9 years: 48% with ankylosing spondylitis (AS), 26% with psoriatic arthritis (PsA), 22% with undifferentiated SpA, and 4% with SpA associated with inflammatory bowel disease (IBD). Uveitis was identified in 17% of patients, ranging from 25% in AS to 4% in PsA. Time from symptom onset to SpA diagnosis was longer in patients with uveitis (10.9 versus 5.9 years, p < 0.001). A higher percentage of patients with uveitis were HLA-B27 positive (85% versus 67%, p = 0.02). The prevalence of uveitis in our population was 17%, slightly lower than previously reported in the literature. There was a diagnostic delay of about 7 years, significantly longer in patients with uveitis. New screening strategies in collaboration with ophthalmology may lead to earlier diagnosis and better outcomes.

摘要

葡萄膜炎可能为更早诊断脊柱关节病(SpA)并影响治疗决策提供机会。我们描述了在一个学术环境中观察到的不同 SpA 患者中急性前葡萄膜炎(AAU)的比例,并根据是否存在葡萄膜炎比较了人口统计学和临床特征。我们对 SpA 和 AAU 患者(2016 年 1 月至 2017 年 6 月)进行了回顾性研究。使用 ICD-10 和行政索赔代码识别患者,通过病历审查确认诊断。提取的数据包括人口统计学、实验室、临床数据、治疗和基于多维健康评估问卷(MDHAQ)的患者指数数据 3(RAPID3)评分。进行了两组间的基线描述和比较。我们纳入了 190 名患者,主要为男性(59.5%),平均年龄 45.9 岁:48%为强直性脊柱炎(AS),26%为银屑病关节炎(PsA),22%为未分化 SpA,4%为与炎症性肠病(IBD)相关的 SpA。17%的患者存在葡萄膜炎,AS 患者中为 25%,而 PsA 患者中为 4%。存在葡萄膜炎的患者从症状出现到 SpA 诊断的时间更长(10.9 年比 5.9 年,p<0.001)。葡萄膜炎患者 HLA-B27 阳性的比例更高(85%比 67%,p=0.02)。我们人群中葡萄膜炎的患病率为 17%,略低于文献报道。存在葡萄膜炎的患者诊断延迟约 7 年,明显长于无葡萄膜炎的患者。与眼科合作开展新的筛查策略可能会导致更早的诊断和更好的结果。

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