華人僵直性脊椎炎疾病的活動指數、功能指數、與臨床表現及症狀治療之相關性

Correlation of BASDAI and BASFI with clinical features and treatment in Chinese patients with ankylosing spondylitis

目的：探討台灣僵直性脊椎炎（AS）患者，其臨床表現（包括年齡、性別、發病、年齡、病程等），與疾病活性度與功能之相關性。方法：收集門診344例AS確診病患，記錄其年齡、性別、發病、年齡、臨床表現（包括關節炎、虹彩炎等），及使用藥物（sulfasalagine, NSAID）等。另外，測量疾病活性度，我們使用BASDAI，測量功能性指標，我們使用BASFI。結果：在收集344AS病患中，255例為男性，89例為女性（男：女 = 2.9:1），在台灣有不同族群分佈比例，閩南AS為69.3%，客家13.2%，外省人12.4%，所有病患平均年齡為36.2，發病年齡為24.98。16歲以下發病者占所有病患35%。有關BASDAI分數，總平均為3.2（範圍0到8.5），而BASFI分數為2.55（0到9.32）。29.9%曾發生過虹彩炎，66.1%有周邊關節炎，47.1%有家族其他病患發生AS。將上述臨床及基本個人資料與BASDAI及BASFI進行相關性比較，結果顯示周邊關節炎與BASDAI有明顯相關。而BASFI與多種臨床資料包括年齡、年齡小於或大於35歲，不同年齡分布、疾病病程、周邊關節炎與非類固醇抗發炎藥物（NSAID）持續使用有明顯相關。結論：本研究顯示周邊關節炎之表現可影響BASDAI與BASFI，然更多之臨床資料包括年齡、疾病病程與NSAID會影響BASFI但不會影BASDAI。及早之診斷與治療，應可避免或減低AS病患晚期功能之喪失。

Objective: To understand the relationship between disease activity or patient functional ability with different clinical parameters (e.g. age, gender, age at onset, disease duration) in our ankylosing spondylitis (AS) patients in Taiwan. Methods: Chinese version of Bath ankylosing spondylitis disease activity index (BASDAI) and Bath ankylosing spondylitis functional index (BASFI) was recently developed and validated by our AS Study Group. We enrolled 344 AS patients and analyzed their demographic and clinical characteristics, sulfasalazine and non-steroidal anti-inflammatory drugs (NSAIDs) use, and clinical outcome by using the Chinese version of BASDAI and BASFI. Results: The 344 AS patients were predominantly male (255) (M:F = 2.9:1) and Taiwanese (69.3%). Hakka and Mainlander ethnicity was 13.2% and 12.4%, respectively. Mean age in the study was 36.2 (M ± SD: 36.2 ± 11.95). Although the mean age at onset was 24.98, 35% of patients had onset of AS before 16 yrs. Average BASDAI score in AS patients was 3.2(range 0-8.5), and BASFI 2.55 (range 0-9.32). Uveitis was present in 29.9% patients and peripheral arthritis developed in 66.1% AS patients. Many patients (47.1%) reported that their family relatives also had AS. Correlation analysis between clinical features and BASDAI showed a significant correlation only between peripheral arthritis and BASDAI (p<0.0001). However, age, age above 35 or below 35 or different age distribution, disease duration, peripheral arthritis and NSAID use, showed a significant correlation with BASFI. Conclusion: The presence of peripheral arthritis can significantly influence both BASDAI and BASFI. The old age, longer disease duration and continuous treatment with NSAIDs was associated with a higher score in BASFI but not BASDAI. Early diagnosis and adequate management may prevent AS patients from later functional impairment.