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强直性脊柱炎患者总体评估的临床价值:一项横断面研究。

Clinical value of the Patient Global Assessment with Ankylosing Spondylitis: A cross-sectional study.

机构信息

Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

Beijing University of Chinese Medicine, Beijing, China.

出版信息

Medicine (Baltimore). 2024 Apr 19;103(16):e37791. doi: 10.1097/MD.0000000000037791.

Abstract

To analyze the factors associated with the overall patient condition and explore the clinical value of the Patient Global Assessment (PGA) index for assessing the disease state in patients with Ankylosing Spondylitis (AS). This cross-sectional study used a standardized questionnaire to record the basic information of patients with AS. The collected data included the Ankylosing Spondylitis Disease Activity Score (ASDAS)-C-reactive protein (CRP), ASDAS-erythrocyte sedimentation rate (ESR), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), PGA, and other clinical indicators. Statistical analysis was performed using SPSS 25.0 software, and the scale was assessed for retest reliability and structural validity. The Kruskal-Wallis H test and Spearman or Pearson correlation analysis were used to analyze the factors influencing PGA scores. The receiver operator characteristic (ROC) curve was used to identify the cutoff value of the PGA for predicting disease activity in AS. The patient age, disease duration, family history, and history of ocular inflammation significantly differed between PGA groups (P < .05). The median PGA was significantly lower in patients with disease remission than in those with disease activity (P < .01). The various clinical indexes significantly differed between PGA groups (P < .01). The PGA was significantly correlated with various clinical indicators (P < .01). The area under the ROC curve (AUC) for disease activity based on the ASDAS-CRP was 0.743 (P < .01) with a PGA cutoff value of 1.38; the AUC for disease activity based on the BASDAI was 0.715 (P < .01) with a PGA cutoff value of 1.63. The PGA was significantly correlated with patient-reported outcomes, disease activity, function, and psychological status, and may indicate the level of inflammation in patients with AS. A PGA of around 1.5 indicates disease activity.

摘要

分析与总体患者状况相关的因素,并探讨患者整体评估(PGA)指数在评估强直性脊柱炎(AS)患者疾病状态中的临床价值。本横断面研究使用标准化问卷记录 AS 患者的基本信息。收集的数据包括强直性脊柱炎疾病活动评分(ASDAS)-C 反应蛋白(CRP)、ASDAS-红细胞沉降率(ESR)、巴斯强直性脊柱炎疾病活动指数(BASDAI)、PGA 及其他临床指标。采用 SPSS 25.0 软件进行统计学分析,对量表进行重测信度和结构效度评估。采用 Kruskal-Wallis H 检验和 Spearman 或 Pearson 相关分析,分析影响 PGA 评分的因素。采用受试者工作特征(ROC)曲线确定 PGA 预测 AS 疾病活动的截断值。患者年龄、病程、家族史和眼部炎症史在 PGA 组间差异有统计学意义(P < .05)。疾病缓解患者 PGA 中位数明显低于疾病活动患者(P < .01)。PGA 组间各临床指标差异有统计学意义(P < .01)。PGA 与各临床指标显著相关(P < .01)。基于 ASDAS-CRP 的疾病活动的 ROC 曲线下面积(AUC)为 0.743(P < .01),PGA 截断值为 1.38;基于 BASDAI 的疾病活动的 AUC 为 0.715(P < .01),PGA 截断值为 1.63。PGA 与患者报告的结局、疾病活动、功能和心理状态显著相关,可能提示 AS 患者的炎症水平。PGA 约为 1.5 时提示疾病活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64f6/11030010/2423e6e880a0/medi-103-e37791-g001.jpg

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