强直性脊柱炎胸腰椎后凸畸形与髋关节病变的相关性分析  

Correlation analysis of thoracolumbar kyphosis and hip involvement in ankylosing spondyUtis patie-

作　　者：胡俊[1] 钱邦平[1] 邱勇[1] 孙凌云 王斌[1] 朱泽章[1] 蒋军[1] 季明亮[1] 王鑫强[1] 

机构地区：[1]南京大学医学院附属鼓楼医院骨科,210008 [2]风湿免疫科

出　　处：《中华风湿病学杂志》2013年第3期155-158,共4页Chinese Journal of Rheumatology

基　　金：江苏省自然科学基金（BK2011092）;江苏省333工程资助项目[（2011）Ⅲ-0079]

摘　　要：目的探讨强直性脊柱炎（AS）胸腰椎后凸畸形患者髋关节病变的危险因素。方法本组66例AS患者，男性57例，女性9例，年龄17～53岁，平均（33＋10）岁，其中50例为AS伴胸腰椎后凸畸形患者（A组），16例为无胸腰椎后凸畸形AS患者（B组）。收集患者的临床资料、实验室检查、影像学资料及生活质量评估量表。临床资料包括年龄和病程；实验室检查包括：红细胞沉降率（ESR）、C反应蛋白（CRP）和人类白细胞抗原（HLA）．B27；影像学资料包括：胸腰椎后凸Cobb角（GK）、髋关节病变评分（BASRI．hip）；生活质量评估量表包括：As疾病活动性量表（BASDAI）、AS功能量表（BASFI）和Oswestw功能障碍量表（ODI）。运用BASRI—hip对髋关节病变进行评分，并定义评分大于2分为有髋关节病变，定义有髋关节病变组为c组，无髋关节病变组为D组。统计学处理采用独立样本t检验和Spearman相关性分析以及多元回归分析。结果A组50例胸腰椎后凸畸形AS患者中，27例（54％）发生髋关节影像学病变，B组16例无胸腰椎后凸畸形AS患者，3例（19％）发生髋关节影像学病变（OR：5．08）。多元回归分析显示GK和病程是AS胸腰椎后凸畸形患者的髋关节病变的高危因素。相关性分析显示BASFI评分与AS患者的髋关节病变显著相关（r=0．345，P=O．014）。结论较大GK和较长病程是AS胸腰椎后凸畸形患者髋关节病变的高危因素，AS患者的髋关节病变显著降低其生活质量。Objective The purpose of this study is to determine the risk factors of hip involvement in ankylosing spondylitis （AS） patients with thoracolumbar kyphosis. Methods Sixty-six consecutive AS patients （group A： fifty AS patients with thoracolumbar kyphosis and group B： sixteen AS patient without thoracolumbar kyphosis） were included in this study. There were 57 males and 9 females, with an average age of 33±10 years （range, 17-53 years）. The clinical data, laboratory data, the radiographical data, and three quality of life questionnaires were recorded. The clinical data included age and disease duration. The laboratory data included erythrocyte sedimentation rate （ESR）, C-reactive protein （CRP）, and HLA-B27. The radiographieal data included global kyphosis angle （GK） and Bath ankylosing spondylitis radiology index-hip score （BASRI-hip）. Three quality of life questionnaires were Bath ankylosing spondylitis disease activity index （BASDAI）, Bath ankylosing spondylitis functional index （BASFI）, and Oswestry disability index （ODI）. Hip involvement was defined as BASRI-hip score greater than 2 （group C： the patients with hip involvement and group D： the padents without hip involvement）. T-test, Spearman＇s test, and multivariate regression ana/ysis were used for statistical analysis. Results Twenty-seven （54%） AS patients in group A and 3（19%） AS patients in group B had radiographieal evidence of hip involvement （OR=5.08）. By the multivariate regression analysis, GK and disease duration were the high risk factors of radiographical hip involvement in AS patients with thoracolumbar kyphosis. BASFI score was significantly correlated with hip involvement （r=0.345, P=0.014）. Conclusion Larger GK and longer disease duration are high risk factors for radiographicai hip involvement in AS patients with thoracolumbar kyphosis. Patients with hip involvement can affect the quality of life in AS patients.

关 键 词：脊柱炎 强直性 后凸 髋关节病变 

分 类 号：R593.23[医药卫生—内科学]