| Abstract: | 僵直性脊椎炎是一種主要侵犯脊椎、周邊關節及著骨點，且可能會出現關節以外症狀的慢性發炎性風濕疾病，患者會因為疼痛、僵硬和疾病持續時間的增加，逐漸造成失能。僵直性脊椎炎是所有常見的免疫引發之風濕疾病中，在盛行率、發生率及臨床表現上，最常有性別差異的疾病之一。然而，僵直性脊椎炎在功能及健康指數是否有性別差異則仍未知。本研究之主要目的為探討僵直性脊椎炎患者在功能及健康指數是否有性別差異。次要目的是探討僵直性脊椎炎患者之疾病活動度是否為功能及健康指數之預測因子。使用臺中榮民總醫院新開發的僵直性脊椎炎電子病歷管理系統，蒐集並紀錄僵直性脊椎炎患者人口統計學，共病和臨床表徵，巴斯僵直性脊椎炎疾病活動指數(BASDAI)，僵直性脊椎炎疾病活動評分(ASDAS)，巴斯僵直性脊椎炎功能指數(BASFI)及脊椎關節炎健康指數(ASAS HI)等臨床數據，選取2017年10月23日至2018年10月22日期間僵直性脊椎炎患者最後一次完整評估的臨床登錄資料進行分析。統計方法使用線性及羅吉斯迴歸分析比較男性與女性之間的功能指數(BASFI)及健康指數(ASAS HI)。本研究共招募307位僵直性脊椎炎患者(245位男性，62位女性)，針對發病年齡、疾病持續期間、抽菸及肝功能以比例1:1配對後，最後納入108位僵直性脊椎炎患者(54位男性，54位女性)。將可能的干擾因素調整過後，男性的健康指數(ASAS HI)顯著低於女性，男性有較好的健康指數(ASAS HI)。然而，功能指數(BASFI)在男性和女性之間沒有顯著差異。功能指數(BASFI)和健康指數(ASAS HI)其他顯著的預測因子包括疾病活動指數(BASDAI)和疾病活動評分(ASDAS-CRP)。根據此單一中心，橫斷性研究之結論，女性的健康指數(ASAS HI)高於男性，女性的健康指數(ASAS HI)較差。然而，功能指數(BASFI)在男性和女性之間沒有顯著差異。疾病活動指數(BASDAI)與疾病活動評分(ASDAS-CRP)是功能指數(BASFI)及健康指數(ASAS HI)顯著的預測因子。
Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease that primarily affects the spine, peripheral joints and enthesitis, with extra-articular manifestations that can progress to significant functional disability. AS is also one of the most common rheumatic diseases that have gender differences in prevalence, incidence and clinical manifestation. However, whether there are gender differences in functional and health indices are still unknown.The primary aim of this study was to investigate the associations of gender with functional and health indices in patients with AS. The secondary objective was to investigate disease activity measures were associated with functional and health indices.We collected and recorded the data of demographic characteristics, comorbidity and clinical manifestations, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Ankylosing Spondylitis Disease Activity Score (ASDAS), the Bath Ankylosing Spondylitis Functional Index (BASFI) and the ASAS Health Index (ASAS HI) for AS patients by using a new electronic medical record management system in Taichung Veterans General Hospital. We retrieved the recorded data of AS patients from October 2017 to October 2018. Then, statistical methods (including multiple linear regression and logistic regression) were applied for the analyses. This study enrolled 307 AS patients including 245 males and 62 females. After matching for the age of onset, disease duration, smoking, liver function with a ratio of 1: 1, we finally included 108 AS patients (54 males and 54 females). After adjusting for potential confounders, males had a significantly lower ASAS HI than females. However, BASFI was not significantly different between males and females. The most significant predictors for BASFI and ASAS HI were BASDAI or ASDAS-CRP, respectively.In conclusion, this single center, cross-sectional study showed females had higher ASAS HI than males. However, BASFI was not significantly different between males and females. Either BASDAI or ASDAS-CRP was a significant predictor for BASFI and ASAS HI. |
