比较国际脊柱关节炎学会、欧洲脊椎关节病研究小组和改良的纽约标准对中国脊柱关节病患者的评估作用

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Clin Rheumatol. 2011 Feb 19. [Epub ahead of print] Comparison of performance of the Assessment of Spondyloarthritis International Society, the European Spondyloarthropathy Study Group and the modified New York criteria in a cohort of Chinese patients with spondyloarthritis. Chung HY, Lau CS, Wu KP, Wong WS, Mok MY. Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, SAR China. Abstract Early diagnosis of spondyloarthritis (SpA) is essential as anti-tumor necrosis factor therapy can achieve significant symptomatic relief and control of disease activity. This study aims to compare the clinical characteristics, disease activity, and functional status of a Chinese cohort of SpA patients who were re-classified into ankylosing spondylitis (AS) patients fulfilling the modified New York (MNY) criteria, those with undifferentiated SpA (USpA) fulfilling the European Spondyloarthropathy Study Group (ESSG) classification criteria only (USpA/ESSG) and those who fulfill Assessment of SpondyloArthritis International Society (ASAS) only (USpA/ASAS). Disease activity was evaluated by Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), severity of morning stiffness, patient global assessment, and C-reactive protein. Functional status was evaluated by Bath Ankylosing Spondylitis Functional Index (BASFI), modified Schober index, and dimension of chest expansion. One hundred and twenty-eight patients with disease duration of 16.3 ± 10.4 years were recruited. Patients in USpA/ESSG and USpA/ASAS were significantly younger (p = 0.01), had shorter disease duration (p < 0.01), and lower BASFI (p = 0.03) than established AS patients. All three groups have active disease with comparable BASDAI >3. BASFI correlated inversely with dimension of chest expansion and negatively modified Schober index in AS patients (p < 0.01) and modestly with BASDAI (r = 0.25, p < 0.01). BASFI correlated moderately with BASDAI in USpA/ESSG (r = 0.61, p < 0.01) but not with chest expansion or modified Schober index. Compared with established AS patients recognized by MNY criteria, patients fulfilling USpA defined by ESSG or ASAS criteria had earlier disease, as active disease and less irreversible functional deficit.

比较国际脊柱关节炎学会、欧洲脊椎关节病研究小组和改良的纽约标准对中国脊柱关节病患者的评估作用 Chung HY, Lau CS, et al,Clin Rheumatol. 2011 Feb 19. [Epub ahead of print] 脊柱关节炎(SpA)的早期诊断与抗肿瘤坏死因子治疗一样，对获得显著症状缓解和控制疾病活动至关重要。本研究目的是比较中国SpA患者中符合改良的纽约标准（MNY）的强直性脊柱炎（AS）、仅符合欧洲脊柱关节病研究小组（ESSG）分类标准的未分化SpA（UspA/ESSG））、以及仅符合国际强直性脊柱炎协会(ASAS)标准的未分化SpA（UspA/ASAS）的患者间的临床特征、疾病活动度和机能状态。疾病活动度评价根据Bath强直性脊柱炎疾病活动指数(BASDAI),晨僵的严重程度、病人的总体评价,和C反应蛋白。功能状态评估根据Bath强直性脊柱炎功能指数(BASFI)、改性Schober指数,和胸廓活动度。共有128例患者入组，平均病程为16.3±10.4年。相比确诊的AS患者，USpA / ESSG和USpA /ASAS患者的年龄更轻(p = 0.01),病程更短(p < 0.01), BASFI值也更低(p = 0.03)。三组患者疾病活动度相似，都 BASDAI > 3。BASFI与胸廓活动度以及改良的Schober指数负相关(p < 0.01),与BASDAI中度相关(r = 0.25, p < 0.01)。BASFI在UspA/ESSG患者中与BASDAI中度相关(r = 0.61,p < 0.01),但与胸廓活动度或修良的Schober指数无相关性。与MNY标准明确诊断的AS患者相比，符合ESSG或ASAS标准的UspA活动性疾病患者的病程较早，不可逆的功能障碍更少。