解放军医学院学报2017，Vol.38Issue(4)：301-305,332,6.DOI:10.3969/j.issn.2095-5227.2017.04.003
强直性脊柱炎患者临床特征和生活质量的性别差异
Gender characterization on the clinical characteristics and life quality of patients with ankylosing spondylitis
摘要
Abstract
Objective To investigate the gender-attributable differences in clinical characteristics and life quality of ankylosing spondylitis (AS) patients. Methods A total of 522 AS patients (80 females and 442 males) were collected from the Department of Rheumatology, Chinese PLA General Hospital from August 2013 to September 2015. A comparison was conducted in terms of age at onset, disease course, family history, HLA-B27, clinical manifestations, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). The disease activity was assessed by the bath ankylosing spondylitis disease activity index (BASDAI) and AS disease activity score (ASDAS), physical function by the bath ankylosing spondylitis functional index (BASFI), spinal mobility by the bath ankylosing spondylitis metrology index (BASMI) and quality of life (QoL) by the Short Form-36 between male and female patients. Results Compared with male patients, female patients were older at disease onset (24.3±9.2vs 20.5±7.5,P < 0.001), and had higher rates of peripheral articular involvement (55.6%vs 40.5%, P < 0.05), and a lower mental health score(54.2±15.4 vs 58.2±16.9, P < 0.05). But no significant gender-attributable difference was observed in other clinical parameters like low back pain, patients'global assessment scores, enthesitis, BASDAI, BASFI and ASDAS. In age < 40 years old group, female patients had lower BASMI scores (0.4±0.9 vs 1.0±1.5, P < 0.05), lower ASDAS scores (2.5±1.3 vs 2.7±1.2, P < 0.05) and lower mental health scores (54.8±14.8 vs 58.5±17.0, P < 0.05) than male. In the age ≥ 40 years old group, female had lower physical functioning (45.6±4.9 vs 75.0±23.9, P < 0.05) and bodily pain scores (42.9±24.1 vs 59.4±22.0, P < 0.05) in SF-36 than man. Female patients with positive HLA-B27 had lower mental health and bodily pain scores (48.6±25.1 vs 55.3±23.2,P <0.05; 53.0±14.5vs 58.1±17.1,P < 0.05), and female patients in highly active disease stage had lower bodily pain score than male patients (29.7±16.3 vs 38.9±18.9, P < 0.05). There was a significant improvement in ASDAS scores in female patients compared with male (1.3±1.7 vs 0.9±1.0, P=0.044). Conclusion AS more likely occurs in older age, had higher rates of peripheral articular involvement, and results in poor QoL in female patients than in male, especially in mental health domain. Moreover, significant impairment of spinal mobility are found in male AS patients.No gender-attributable differences in disease activity or physical function are found between male and female patient, which indicating that female disease should be paid the same attention on as male patients in clinical diagnosis and treatment.关键词
强直性脊柱炎/性别/临床特征/生活质量Key words
ankylosing spondylitis/gender/clinical characteristics/quality of life分类
医药卫生引用本文复制引用
孙卓,冀肖健,文琼芳,高岱,杨金水,朱剑,张江林,黄烽..强直性脊柱炎患者临床特征和生活质量的性别差异[J].解放军医学院学报,2017,38(4):301-305,332,6.基金项目
国家科技部支撑计划课题(2014BAI07B05) （2014BAI07B05）
国家重点基础研究发展计划(2014CB541806) Supported by the National Science and Technology Infrastructure Program (2014BAl07B05) （2014CB541806）
Special Foundation for State Major Basic Research Program of China (2014CB541806) （2014CB541806）
