埃及脊柱关节炎谱系及疾病特征的全国性研究。

Nationwide study of spondyloarthritis spectrum and disease characteristics in Egypt.

作者信息

Emad Yasser, Elsaman Ahmed, El-Saadany Hanan, ElShereef Rawhya R, Hisham Yousra, Farouk AlShaymaa, Elsehrawy Gehad G, Tharwat Samar, Amer Marwa A, Hammam Osman, Hammam Nevin, ElBahnasawy Amany S, Fawzy Rasha, Elshabacy Fatemah, Khalifa Asmaa, Moshrif Abdelhfeez, Ismail Faten, Elwan Shereen, Abdelsalam Mahmoud A, Ibrahim Amira M, Gheita Tamer A

机构信息

Rheumatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Rheumatology Department, Faculty of Medicine, Sohag University, Sohag, Egypt.

出版信息

Sci Rep. 2025 Aug 13;15(1):29676. doi: 10.1038/s41598-025-15046-0.

DOI:10.1038/s41598-025-15046-0

PMID:40804081

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12350779/

Abstract

The aim of this study was to describe the array and disease characteristics of spondyloarthritis (SpA) across Egypt. This work included 1401 SpA patients recruited from 15 specialized Egyptian rheumatology centers representing 20 major cities. The demographic and clinical features, as well as the therapeutic data, were recorded. The mean age of the patients was 37.6 ± 11.4 years, disease duration 8.01 ± 6.7 years, and age at onset 29.9 ± 11 years; 148 (10.6%) were juvenile-onset. There were 813 males and 588 females (M: F 1.4:1). 5.7% were diabetic, 6.1% hypertensive, and 19.3% were smokers. The mean BASDAI was 3.98 ± 1.78, and the BASFI was 4.02 ± 1.77. The human leukocytic antigen (HLA-B27) was positive in 19.8%. Biologic therapy was received by 55.5%, followed by methotrexate (36%) ,steroids (10.8%), and sulfasalazine in 10.7%. In males, the age at onset was significantly lower (p = 0.02), while radiographic axSpA, neuropsychiatric and pulmonary manifestations, HLA-B27 positivity, and receiving biologic therapy were significantly higher (p = 0.02, p < 0.0001, p = 0.03, p < 0.0001, and p < 0.0001). In females, cutaneous manifestations and arthritis were significantly more frequent (p < 0.0001 and p < 0.0001). Those with positive HLA-B27 had a significantly higher frequency of AS (73%) (p = 0.003), male gender (66.2%) (p < 0.0001), longer disease duration (p = 0.001), and were receiving a higher frequency of biologic therapy (89%, p < 0.0001). Radiographic axial SpA was most reported from Assuit (15.9%), nr-axSpA from Cairo (24.5%), peripheral arthritis only from Giza (30.7%), and unclassified from Kafr ElSheikh (33.9%) (p = 0.002). The spectrum of SpA in Egypt is inconsistent across the country. Gender, disease subtype, and HLA-B27 seem to play a key role in the phenotypic presentation.

摘要

本研究旨在描述埃及各地脊柱关节炎（SpA）的类型及疾病特征。这项工作纳入了从代表20个主要城市的15家埃及专业风湿病中心招募的1401例SpA患者。记录了患者的人口统计学和临床特征以及治疗数据。患者的平均年龄为37.6±11.4岁，病程为8.01±6.7年，发病年龄为29.9±11岁；148例（10.6%）为青少年发病。男性813例，女性588例（男：女为1.4：1）。5.7%患有糖尿病，6.1%患有高血压，19.3%为吸烟者。平均巴斯强直性脊柱炎疾病活动指数（BASDAI）为3.98±1.78，巴斯强直性脊柱炎功能指数（BASFI）为4.02±1.77。人类白细胞抗原（HLA - B27）阳性率为19.8%。55.5%的患者接受了生物治疗，其次是甲氨蝶呤（36%）、类固醇（10.8%）和柳氮磺胺吡啶（10.7%）。在男性中，发病年龄显著更低（p = 0.02），而放射学轴性SpA、神经精神和肺部表现、HLA - B27阳性率以及接受生物治疗的比例显著更高（p = 0.02、p < 0.0001、p = 0.03、p < 0.0001和p < 0.0001）。在女性中，皮肤表现和关节炎明显更常见（p < 0.0001和p < 0.0001）。HLA - B27阳性者中强直性脊柱炎（AS）的发生率显著更高（73%）（p = 0.003），男性比例更高（66.2%）（p < 0.0001），病程更长（p = 0.001），接受生物治疗的频率也更高（89%，p < 0.0001）。放射学轴性SpA在阿斯尤特报告最多（15.9%），非放射学轴性SpA在开罗最多（24.5%），仅外周关节炎在吉萨最多（30.7%），未分类SpA在卡夫尔谢赫最多（33.9%）（p = 0.002）。埃及SpA的类型在全国范围内不一致。性别、疾病亚型和HLA - B27似乎在表型表现中起关键作用。