脊柱关节病患者康复治疗的依从性分析  

Analysis of adherence to rehabilitation therapy in patients with spondyloarthropathy

作　　者：李春敏 李宏超 满斯亮 王玲艳 徐松 张亮 潘靖 LI Chunmin;LI Hongchao;MAN Siliang;WANG Lingyan;XU Song;ZHANG Liang;PAN Jing(Department of Orthopaedics,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;Department of Rheumatology and Immunology,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;Department of Dermatology,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China;Department of Arthrology,Yuxi Hospital,Wuxi County,Chongqing 405800,China)

机构地区：[1]首都医科大学附属北京积水潭医院矫形骨科,北京100035 [2]首都医科大学附属北京积水潭医院风湿免疫科,北京100035 [3]首都医科大学附属北京积水潭医院皮肤科,北京100035 [4]重庆市巫溪县渝溪医院关节科,重庆405800

出　　处：《中华骨与关节外科杂志》2024年第3期240-245,共6页Chinese Journal of Bone and Joint Surgery

摘　　要：目的:评估脊柱关节病(SpA)患者康复治疗的依从性,并分析SpA患者康复治疗依从性不佳的相关因素。方法:回顾性纳入2021年3月至2023年7月门诊就诊的435例SpA患者,收集患者的人口学资料、疾病相关数据、实验室检查及影像学检查结果。康复治疗依从性态度评价采用18项康复训练态度评估问卷(EAQ)。以50分作为依从性分界值,将患者分为依从性良好组和依从性不佳组并进行组间比较。将单因素分析所得具有显著性意义的因素纳入多因素逻辑回归分析,评估具有统计学意义的相关因素。结果:EAQ评分为48.1(40.7,55.6)分,其中249例(57.2%)判定为依从性不佳。两组间比较结果提示以下参数存在显著性差异:就诊年龄(P<0.001)、诊断年龄(P=0.004)、疾病病程(P<0.001)、诊断延迟(P<0.001)、长期居住地农村(P=0.021)、合并银屑病(P=0.012)、合并炎性肠病(IBD)(P=0.012)、血红蛋白(HGB)水平(P<0.001)、红细胞沉降率(ESR)(P=0.006)、C反应蛋白(CRP)水平(P=0.016)、白蛋白(ALB)水平(P=0.001)、使用非甾体抗炎药(NSAIDs)(P=0.005)、巴氏强直性脊柱炎疾病活动指数(BASDAI)(P<0.001)及巴氏强直性脊柱炎功能指数(BASFI)(P=0.018)。多因素逻辑回归分析结果提示SpA患者康复治疗依从性不佳的相关因素包括:合并IBD(OR=3.132,P=0.047)、使用NSAIDs(OR=1.998,P=0.002)、BASDAI(OR=1.148,P=0.012)、疾病病程(OR=1.061,P<0.001)和ESR(OR=1.014,P=0.009)。结论:SpA患者康复治疗依从性不佳的相关因素包括合并IBD、使用NSAIDs、BASDAI升高、长病程及ESR升高。Objective:To assess adherence to rehabilitation therapy among patients with spondyloarthritis(SpA)and to analyze factors affecting adherence.Methods:Four hundred and thirty-five outpatients with SpA between March 2021 and July 2023 were retrospectively enrolled.Sociodemographic information,disease-related data,laboratory examinations,and imaging findings were collected.Patients'adherence to rehabilitation therapy was assessed using the 18-item Exercise Attitude Questionnaire(EAQ).Patients were categorized into groups of good adherence and poor adherence based on a cutoff score of 50,and intergroup comparisons were performed.Significant factors identified through univariate analysis were included in a multivariate logistic regression analysis to assess statistically significant factors related to poor adherence.Results:The median EAQ score was 48.1(40.7,55.6),with 249 patients(57.2%)determined to have poor adherence.Comparative analysis between the two groups revealed significant differences in the following parameters:age at diagnosis(P<0.001),age at onset of symptoms(P=0.004),duration of illness(P<0.001),diagnostic delay(P<0.001),rural residence(P=0.021),comorbid psoriasis(P=0.012),comorbid inflammatory bowel disease(IBD)(P=0.012),hemoglobin level(P<0.001),erythrocyte sedimentation rate(ESR)(P=0.006),C-reactive protein level(P=0.016),albumin level(P=0.001),current use of nonsteroidal anti-inflammatory drugs(NSAIDs)(P=0.005),Bath ankylosing spondylitis disease activity index(BASDAI)(P<0.001),and Bath ankylosing spondylitis functional index(BASFI)(P=0.018).Multivariate logistic regression analysis revealed that factors associated with poor adherence to rehabilitation treatment in SpA patients included comorbid IBD(OR=3.132,P=0.047),current use of NSAIDs(OR=1.998,P=0.002),the BASDAI(OR=1.148,P=0.012),the duration of illness(OR=1.061,P<0.001),and the ESR(OR=1.014,P=0.009).Conclusions:Factors associated with poor adherence to rehabilitation treatment in SpA patients include comorbid IBD,current use of NSAIDs,elevated

关 键 词：脊柱关节病 康复治疗 依从性 

分 类 号：R681[医药卫生—骨科学]