TÜrk İpek, CÜzdan Nihan, ÇİftÇİ Volkan, Arslan Didem, Ünal İlker
Department of Internal Medicine, Division of Rheumatology, Çukurova University Faculty of Medicine, Adana, Turkey.
Department of Physical Medicine and Rehabilitation, Division of Rheumatology, Çukurova University Faculty of Medicine, Adana, Turkey.
Arch Rheumatol. 2020 Feb 7;35(2):196-204. doi: 10.46497/ArchRheumatol.2020.7434. eCollection 2020 Jun.
This study aims to investigate the correlations between clinical features and mouth opening in patients with systemic sclerosis (SSc).
Eighty patients with SSc (13 males, 67 females; mean age 53.39±11.65 years; range, 31 to 76 years) followed in our clinic were enrolled in the study. Skin involvement was assessed using the modified Rodnan skin score (mRSS), joint/tendon involvement with finger-tip to palm (FTP) distance and interstitial lung disease (ILD) was evaluated with clinical and radiologic methods. The interincisal distance (ID) measurement was used to assess the maximal mouth opening capacity. We examined associations between the ID and clinical features of SSc.
The ID was lower in females compared with males, and in diffuse type compared with the limited type (p<0.001 and p<0.001, respectively). A significant negative correlation was found between the ID with mRSS and FTP distance (p<0.001 and p=0.001, respectively). The ID was lower in patients with ILD than in patients without ILD (p=0.006). A formula was constituted to predict the maximal mouth opening of the patient with regression analysis. According to the formula, being male was associated with an increase of 6.14 mm, the presence of ILD with a decrease of 3.19 mm, every 10 mm increment in mRSS with a decrease of 3.72 mm and FTP distance >0 mm with a decrease of 5.13 mm in mouth opening.
Microstomia is associated with low quality of life in patients with SSc. In our study, sex, ILD, mRSS, and FTP distance were observed to be the most important factors that were related with mouth opening in patients with SSc.
本研究旨在调查系统性硬化症（SSc）患者的临床特征与张口度之间的相关性。
本研究纳入了在我们诊所随访的80例SSc患者（男性13例，女性67例；平均年龄53.39±11.65岁；范围31至76岁）。使用改良Rodnan皮肤评分（mRSS）评估皮肤受累情况，通过指尖至手掌（FTP）距离评估关节/肌腱受累情况，并采用临床和放射学方法评估间质性肺疾病（ILD）。使用切牙间距离（ID）测量来评估最大张口能力。我们研究了ID与SSc临床特征之间的关联。
女性的ID低于男性，弥漫型的ID低于局限型（分别为p<0.001和p<0.001）。发现ID与mRSS和FTP距离之间存在显著负相关（分别为p<0.001和p = 0.001）。ILD患者的ID低于无ILD患者（p = 0.006）。通过回归分析构建了一个预测患者最大张口度的公式。根据该公式，男性与张口度增加6.14 mm相关，ILD的存在与张口度降低3.19 mm相关，mRSS每增加10 mm与张口度降低3.72 mm相关，FTP距离>0 mm与张口度降低5.13 mm相关。
小口症与SSc患者的生活质量低下相关。在我们的研究中，性别、ILD、mRSS和FTP距离被观察到是与SSc患者张口度相关的最重要因素。
