Gorial Faiq I, Jabbar Mais Ajeel
Department of Medicine, Collage of Medicine, University of Baghdad, Iraq.
Baghdad Teaching Hospital, Rheumatology Unit, Baghdad, Iraq.
Ann Med Surg (Lond). 2020 Apr 13;54:43-46. doi: 10.1016/j.amsu.2020.03.010. eCollection 2020 Jun.
Behçet's syndrome (BD) is a systemic inflammatory vasculitis of unknown aetiology, affecting vessels of different types, sizes and locations and characterized by recurrent episodes of acute inflammation, including mucocutaneous manifestations (oral aphthous ulcers, genital ulcers and skin lesions) and gastrointestinal, musculoskeletal, neurological, ophthalmic and vascular involvement which lead to a significant morbidity and impaired health related quality of life (HRQoL). Few studies reported impact of disease activity on HRQoL.
To assess the impact of BD activity on HRQoL.
This cross sectional study included patients with Behçet's disease diagnosed according to the International Study Group criteria 1990 for BD. Age of the patients, sex, smoking status, educational level, disease duration, organ involvement, age at disease onset, and medications used were recorded. Behçet's Disease Disease activity was assessed using Behçet's Disease Current Activity Form (BDCAF) and HRQoL was evaluated using The Short Form-36 (SF-36).
A total of 71 patients (45 males, 26 females) with Behçet's disease were enrolled in this study. Mean age of patients was 36.0 ± 10.8 years, Males represented the majority of patients (63.4%). BDCAF was significantly and negatively correlated with total SF-36 score (standardized β = - 0.520, p < 0.0001). The mean BDCAF was significantly more in females compared to males (6.154 ± 2.444 vs 4.467 ± 2.785, p = 0.012). While the mean SF36 was significantly more in males compared to females (57.722 ± 21.627 vs 41.435 ± 18.993, p = 0.002). After multiple linear stepwise regression analysis, still BDCAF significantly and negatively affected HRQoL in BD (partial r = -0.255, p = 0.043). Male gender, cyclosporine users, infliximab users, and Adalimumab users had significant positive impact on total SF-36 score (partial r = 0.293, p = 0.020; partial r = 0.256, p- = 0.043, partial r = 0.414; p = 0.00, partial r = 0.399, p = 0.001 respectively). While disease duration, and MMF users (partial r = -0.295, p = 0.019; partial r = -0.250, p = 0.043) had significant negative impact on total SF-36 score, and there was weak positive correlation between vascular involvement and total SF36 score (partial r = 0.244,p = 0.053) and a negative weak correlation between the use of anticoagulant with total SF-36 score (partial r = -0.233, p = 0.066).
Behçet's disease activity has a significant negative impact on HRQoL This may suggest that treating activity of disease may improve HRQoL
白塞病（BD）是一种病因不明的全身性炎症性血管炎，可影响不同类型、大小和位置的血管，其特征为急性炎症反复发作，包括黏膜皮肤表现（口腔溃疡、生殖器溃疡和皮肤病变）以及胃肠道、肌肉骨骼、神经、眼部和血管受累，这些会导致显著的发病率和健康相关生活质量（HRQoL）受损。很少有研究报道疾病活动对HRQoL的影响。
评估BD活动对HRQoL的影响。
这项横断面研究纳入了根据1990年国际研究组标准诊断为白塞病的患者。记录患者的年龄、性别、吸烟状况、教育水平、病程、器官受累情况、发病年龄以及使用的药物。使用白塞病当前活动表（BDCAF）评估白塞病的疾病活动，并使用简短健康调查问卷（SF - 36）评估HRQoL。
本研究共纳入71例白塞病患者（45例男性，26例女性）。患者的平均年龄为36.0±10.8岁，男性占大多数（63.4%）。BDCAF与SF - 36总分呈显著负相关（标准化β=-0.520，p<0.0001）。女性的平均BDCAF显著高于男性（6.154±2.444 vs 4.467±2.785，p = 0.012）。而男性的平均SF36显著高于女性（57.722±21.627 vs 41.435±18.993，p = 0.002）。经过多元线性逐步回归分析，BDCAF仍对白塞病患者的HRQoL有显著负面影响（偏相关系数r=-0.255，p = 0.043）。男性、使用环孢素的患者、使用英夫利昔单抗的患者以及使用阿达木单抗的患者对SF - 36总分有显著的正向影响（偏相关系数r分别为0.293，p = 0.020；0.256，p = 0.043；0.414，p = 0.00；0.399，p = 0.001）。而病程以及使用吗替麦考酚酯的患者（偏相关系数r=-0.295，p = 0.019；r=-0.250，p = 0.043）对SF - 36总分有显著负面影响，血管受累与SF36总分之间存在弱正相关（偏相关系数r = 0.244，p = 0.053），使用抗凝剂与SF - 36总分之间存在弱负相关（偏相关系数r=-0.233，p = 0.066）。
白塞病活动对HRQoL有显著负面影响。这可能表明治疗疾病活动可能改善HRQoL
