银屑病关节炎患者关节受累与否与生活质量及其与关节周围骨变化的关系。
Quality of life and its relation to periarticular bone changes in psoriatic patients with or without joint involvement.
机构信息
Pysical Medicine, Rheumatology and Rehabilitation Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
出版信息
Clin Rheumatol. 2021 Aug;40(8):3175-3183. doi: 10.1007/s10067-021-05641-7. Epub 2021 Feb 25.
OBJECTIVES
To assess periarticular bone changes in psoriasis patients with or without joint involvement and its effect on patients' quality of life (QoL).
METHODS
This cross-sectional study enrolled 50 patients with psoriasis (25 only with skin psoriasis (PsO) and 25 with psoriatic arthritis (PsA)), as well as 25 healthy controls. All participants were analyzed by high-resolution computed tomography (HR-CT) scans of the dominant hand (second and third metacarpophalangeal joints) for detection of new bone formation (enthesophytes) and erosions. Demographic, laboratory, clinical, and disease-specific data, including physical function and QoL, were collected.
RESULTS
Physical function and QoL scores were significantly worse in the PsA patients than in the PsO patients. All 25 PsA patients (100%), 18 PsO patients (72%), and 5 healthy individuals (20%) had periarticular bone changes. Statistically significant higher erosion number and volume as well as higher enthesophyte number and height were found in PsA patients compared to both PsO patients and controls, and in PsO patients compared to controls. In PsO patients, the number of erosions and enthesophytes had a negative correlation with some Short Form (SF)-36 sub-scores. In the PsA patients, the number of erosions had a positive correlation with psoriasis disability index, while the number of enthesophytes had a negative correlation with the general health SF-36 sub-score.
CONCLUSION
In PsO patients, there may be subclinical periarticular inflammation (erosions and enthesophytes) that raise the suspicion of occult PsA or the possibility of PsO transition to PsA and these periarticular bone changes may worsen QoL in PsO patients. Key Points • Skin psoriasis patients may have subclinical PsA. • Periarticular bone changes in PsO patients may be the early sign for uploading PsA disease. • Quality of life is highly affected in PsA than in PsO patients.
目的
评估有或无关节受累的银屑病患者的关节周围骨变化及其对患者生活质量（QoL）的影响。
方法
这项横断面研究纳入了 50 名银屑病患者（25 名仅有皮肤银屑病（PsO），25 名患有银屑病关节炎（PsA））以及 25 名健康对照者。所有参与者均接受了优势手（第二和第三掌指关节）的高分辨率计算机断层扫描（HR-CT）检查，以检测新骨形成（附着点炎）和侵蚀。收集了人口统计学、实验室、临床和疾病特异性数据，包括身体功能和 QoL。
结果
与 PsO 患者相比，PsA 患者的身体功能和 QoL 评分明显更差。25 名 PsA 患者（100%）、18 名 PsO 患者（72%）和 5 名健康个体（20%）均存在关节周围骨改变。与 PsO 患者和对照组相比，PsA 患者的侵蚀数量和体积以及附着点炎数量和高度均显著更高，与对照组相比，PsO 患者的侵蚀数量和附着点炎数量也更高。在 PsO 患者中，侵蚀和附着点炎的数量与一些 SF-36 子量表评分呈负相关。在 PsA 患者中，侵蚀的数量与银屑病残疾指数呈正相关，而附着点炎的数量与一般健康 SF-36 子量表评分呈负相关。
结论
在 PsO 患者中，可能存在亚临床关节周围炎症（侵蚀和附着点炎），这提示隐匿性 PsA 或 PsO 向 PsA 转化的可能性，这些关节周围骨改变可能会使 PsO 患者的 QoL 恶化。
关键点
皮肤银屑病患者可能患有亚临床银屑病关节炎。
PsO 患者的关节周围骨改变可能是 PsA 疾病进展的早期征象。
与 PsO 患者相比，PsA 患者的生活质量受影响更大。
Zotero 插件