强直性脊柱炎新的疾病活动性指数在中国患者中的应用价值研究  

The value of ankylosing spondylitis disease activity score in Chinese ankylosing spondylitis patients

作　　者：许漫龙[1] 林智明[1] 廖泽涛[1] 黄进贤[1] 李丽[1] 魏艳林[1] 魏秋静[1] 李秋霞[1] 谢颖颖[1] 张艳丽[1] 李天旺[1] 古洁若[1] 

机构地区：[1]中山大学附属第三医院风湿科,广州510630

出　　处：《中华风湿病学杂志》2010年第3期177-181,共5页Chinese Journal of Rheumatology

基　　金：广东省科技计划项目（2005A30801005）;广州市科技攻关项目（200622-E0221）;卫生部临床学科重点项目（2007）;中山大学5010项目（2007023）

摘　　要：目的验证新的强直性脊柱炎（AS）疾病活动性指数（ASDAS）在中国的AS患者中的辨别能力，评估其临床应用价值。方法本研究共纳入AS患者129例，分别为参加依那西普临床试验的活动期AS患者（87例）和使用类克治疗的AS患者（42例）。分别以4个ASDAS、毕氏AS疾病活动指数（BASDAI）及患者总体评价来评价患者的疾病活动性水平和治疗效果。计算标准化的均数差（SMD）分析指标的辨别能力，运用Pearson相关分析，两独立样本t检验与一元线性回归进行统计学处理。结果无论是基线水平还是治疗6周后的变化程度，4个新的ASDAS均与患者总体评价（r=0．56～0．74）、红细胞沉降率（ESR）（r=0．50-0．80）及c反应蛋白（CRP）（r=0．50～0．69）有较好的相关性。4个ASDAS对AS患者的疾病活动性水平及治疗前后病情变化程度的辨别能力均优于BASDAI、患者总体评价、ESR和CRP。4个ASDAS之间差异无统计学意义。结论新的ASDAS用于评价我国AS患者的疾病活动性和药物疗效有较高的辨别能力，值得临床推广和应用。Objectives To validate the discriminatory capacity of the new ankylosing spondylitis disease activity scores （ASDAS） in Chinese ankylosing spondylitis （AS） patients, and assess its clinical value. Method One hundred and twenty-nine patients with AS was included in the study, in which 87 were participat clinical trials with Etanercept （n=87） and 42 were participants of clinical trails with. The disease activity and treatment effecticacy were assessed by ASDAS, BASDAI and patient global assessment. Discriminatory ability of all the measures was analyzed as standardized mean difference （SMD） and t-score. Pearson＇s correlation, two indepen-dent samples t test and simple linear regression model were used for statistical analysis. Result The four ASDAS scores correlated well with patient global assessment （r=0.56-0.74）, ESR （r=0.50-0.80） and CRP （r=0.50-0.69） both at baseline and the changes form baseline to 6 weeks after treatment. The four ASDAS outperformed BASDAI, patient global assessment, ESR and CRP in differentiating patients with different levels of disease activity and patients with different levels of change. There was little difference in performance between the four ASDAS versions. Conclusion The four ASDAS are highly discriminatory in evaluating the disease activity and the efficacy of drugs in Chinese AS patients, showing a significant value in clinical practice.

关 键 词：脊柱炎 强直性 治疗结果 疾病活动性指数 

分 类 号：R593.23[医药卫生—内科学]