强直性脊柱炎髋关节病变的相关因素分析

目的 探讨强直性脊柱炎(AS)患者髋关节病变的危险因素.方法 将同期住院的102例有髋关节破坏性病变的AS患者(A组)和54例无髋关节破坏性病变的患者(B组)临床资料和治疗方法分别进行单因素和非对称多因素Logistic回归分析.结果 A组患者比B组发病年龄早[(17±8)岁与(24±7)岁]、病程短[(5±4)年与(11±5)年]、幼年发病多见(37.3%与20.4%)、首发髋关节起病较多(38.2%与25.9%),以及外周关节炎重(39.2%与20.4%),差异均有统计学意义(P均＜0.05).A组患者红细胞沉降率(ESR)、C反应蛋白(CRP)、免疫球蛋白(IgG、IgM)水平,以及骶髂关节病变率显著高于B组(P均＜0.05).A组使用糖皮质激素剂量显著多于B组,使用柳氮磺吡啶和沙利度胺剂量显著少于B组(P均＜0.05).Logistic回归分析显示仅有5个髋关节病变相关因素,包括发病年龄、病程、幼年发病、首发髋关节起病以及服用柳氮磺吡啶(P＜0.05或P＜0.01).结论 发病年龄早、幼年发病、病程短以及髋关节起病的AS患者可能易于发生首发髋关节病变,而足量的柳氮磺吡啶可能是AS起病发生髋关节病变的保护因素.

A multi-factor analysis on the prevalence of lesion of hip joint in patients with ankylosing spondylitis

Objective To analyze the multiple factors for ankylosing spondylitis(AS)patients developing hip joint disease. Methods One hundred and two patients with AS complicated with hip joint damage (group A)were compared with 54 patients with AS without hip joint disease(group B). A univariate and multivariate unconditional-Logistic regression analysis was carried. Results The mean age at the time of disease onset was(17±8)years old in group A and(24±7)years in group B(P＜0.05). The course of disease onset was(5±4)years old in group A and(11±5)years in group B(P＜0.05). The childhood of disease onset was 37.3% in group A and 20.4% in group B(P＜0.05). The patients who had hip pain at the disease onset was 38.2% in group A and 25.9% in group B(P＜0.05).The incidence of peripheral arthritis was 39.2% and 20.4%(P＜0.05)in patients of group A and group B respectively. Laboratory and X-ray findings showed that ESR, CRP, IgG and IgM levels were higher in group A than those in group B. SASP and thalidomide dosage taken in group A was lower than that in group B(P＜0.01), the dosage of prednisone taken was higher in group A than in group B. A multivariate unconditional logistic regression analysis showed 5 factors, including the younger age of the time of disease onset, the short disease duration, the childhood of disease onset and hip joint involvement at the onset were associated with the occurrence of hip joint involvement. Conclusion The younger age, childhood and hip joint involvement at the time of disease onset, short disease duration may be the risk factors and SASP may be the protecting factor for patients developing hip joint lesion. More cases and factors analysis may be helpful to predict hip joint lesion in AS and to reduce the prevalence of disability.