轴向影像学损伤在中轴型脊柱关节炎中的临床意义：客观电子设备评估其功能后果。
Clinical Relevance of Axial Radiographic Damage in Axial Spondyloarthritis: Evaluation of Functional Consequences by an Objective Electronic Device.
机构信息
D. Kiefer, MD, J. Braun, MD, V. Chatzistefanidi, MD, U. Kiltz, MD, X. Baraliakos, MD, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Bochum;
D. Kiefer, MD, J. Braun, MD, V. Chatzistefanidi, MD, U. Kiltz, MD, X. Baraliakos, MD, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Bochum.
出版信息
J Rheumatol. 2023 Nov;50(11):1422-1429. doi: 10.3899/jrheum.2022-1240. Epub 2023 Apr 15.
OBJECTIVE
Axial spondyloarthritis (axSpA) is associated with decreased function and mobility of patients as a result of inflammation and radiographic damage. The Epionics SPINE device (ES), an electronic device that objectively measures spinal mobility, including range of motion (RoM) and speed (ie, range of kinematics [RoK]) of movement, has been clinically validated in axSpA. We investigated the performance of the ES relative to radiographic damage in the axial skeleton of patients with axSpA.
METHODS
A total of 103 patients with axSpA, 31 with nonradiographic axSpA (nr-axSpA) and 72 with radiographic axSpA (r-axSpA), were consecutively examined. Conventional radiographs of the spine (including presence, number, and location of syndesmophytes) and the sacroiliac joints (SIJs; rated by the modified New York criteria) were analyzed with the ES. Function and mobility were assessed using analyses of covariance and Spearman correlation.
RESULTS
The number of syndesmophytes correlated positively with Bath Ankylosing Spondylitis Metrology Index scores ( 0.38, = 0.02) and correlated negatively with chest expansion ( -0.39, = 0.02) and ES measurements (-0.53 ≤ ≤ -0.34, all < 0.03), except for RoM and RoK regarding rotation and RoK for extension of the lumbar and thoracic spines. In the radiographic evaluation of the SIJs, the extent of damage correlated negatively with ES scores and metric measurements (-0.49 ≤ ≤ -0.33, all < 0.001). Patients with r-axSpA, as compared to those with nr-axSpA, showed significantly worse ES scores for RoM, RoK, and chest expansion.
CONCLUSION
The ES scores, in accordance with mobility measurements, correlated well with the presence and extent of radiographic damage in the spine and the SIJs. As expected, patients with r-axSpA had more severe impairments than those with nr-axSpA.
目的
轴性脊柱关节炎（axSpA）可导致患者的功能和活动能力下降，这是炎症和放射学损伤的结果。Epionics SPINE 设备（ES）是一种电子设备，可客观测量脊柱活动度，包括运动的活动范围（RoM）和速度（即运动范围的运动学[RoK]），已在 axSpA 中得到临床验证。我们研究了 ES 相对于 axSpA 患者轴向骨骼放射学损伤的表现。
方法
共连续检查了 103 例 axSpA 患者，其中 31 例为非放射学 axSpA（nr-axSpA），72 例为放射学 axSpA（r-axSpA）。对脊柱（包括骨桥的存在、数量和位置）和骶髂关节（SIJ；按改良纽约标准评分）的常规放射照片进行了 ES 分析。使用协方差分析和斯皮尔曼相关性对功能和活动度进行了评估。
结果
骨桥的数量与巴斯强直性脊柱炎计量学指数评分呈正相关（ 0.38， = 0.02），与胸廓扩张呈负相关（ -0.39， = 0.02），与 ES 测量值呈负相关（-0.53 ≤ ≤ -0.34，所有 < 0.03），除了腰椎和胸椎旋转的 RoM 和 RoK 以及伸展的 RoK。在 SIJ 的放射学评估中，损伤程度与 ES 评分和度量测量值呈负相关（-0.49 ≤ ≤ -0.33，所有 < 0.001）。与 nr-axSpA 患者相比，r-axSpA 患者的 RoM、RoK 和胸廓扩张 ES 评分明显更差。
结论
ES 评分与运动度测量值与脊柱和 SIJ 的放射学损伤的存在和程度密切相关。正如预期的那样，r-axSpA 患者的损伤比 nr-axSpA 患者更严重。
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