CAJ | 학술논문

目的：探讨男女性强直性脊柱炎（ankylosing spondylitis，AS）胸腰椎后凸畸形患者临床特征及生活质量的差异。方法：选取2009年5月~2013年2月在我院手术治疗的51例AS患者，其中男31例，女20例，年龄21~62岁，平均40.6岁。所有患者均填写Oswestry功能障碍指数（Oswestry disability index，ODI）、巴氏AS疾病活动指数（Bath ankylosing spondylitis disease activity index，BASDAI）、巴氏AS 功能指数（Bath ankylosing spondylitis functional index，BASFI）、巴氏AS 计量指数（Bath ankylosing spondylitis metrology index，BASMI）、巴氏 AS 总体评分（Bath ankylosing spondylitis global score，BAS-G）、巴氏 AS 放射指数（Bath ankylosing spondylitis radiology index，BASRI）及SF-36量表；同时记录其发病年龄、病程、血沉（erythrocyte sedimentation rate，ESR）、C反应蛋白（C-reactive protein，CRP）、人类白细胞抗原-B27亚型（HLA-B27）；在立位全脊柱侧位X线片上测量全脊柱最大后凸角（global kyphosis，GK）、腰椎前凸角（lumbar lordosis，LL）、胸椎后凸角（thoracic kyphosis，TK）、矢状面平衡（sagittal vertical axis，SVA）、骨盆投射角（pelvic incidence，PI）、骨盆倾斜角（pelvic tilting，PT）及骶骨倾斜角（sacral slope，SS）。比较男性组与女性组发病年龄、病程、ESR、CRP、HLA-B27阳性率、TK、GK、LL、SVA、PI、PT、SS、ODI、BASDAI、BASFI、BASMI、BAS-G、BASRI及SF-36量表各维度之间的差异。结果：男女比例为1.6∶1。与男性组比较，女性组发病年龄较晚、病程较短、ESR和CRP水平较高及HLA-B27阳性率较低（P<0.05）。与男性组比较，女性组表现出较高的ODI、BASDAI、BASRI 评分及较低的BASMI 评分（P<0.05），两组BASFI及BAS-G无统计学差异（P＞0.05）。脊柱-骨盆矢状面参数中，与男性组比较，女性组表现出较大的GK、SVA（P<0.05），两组TK、LL、PI、PT及SS均无统计学差异（P＞0.05）。SF-36量表各维度中，女性组情感职能得分、精神健康得分低于男性组，而生理功能得分、社会功能得分高于男性组（P<0.05），两组生理职能、身体疼痛、总体健康状况及活力得分无统计学差异（P＞0.05）。结论：在行手术治疗的AS患者中，男女比例为1.6∶1。与男性AS患者相比，女性患者病情较重，且发病年龄较晚，病程较短。此外，男性AS患者生理功能、社会功能受到明显的限制，而女性AS患者情感职能、精神健康受到明显的损害。目的：探討男女性彊直性脊柱炎（ankylosing spondylitis，AS）胸腰椎後凸畸形患者臨床特徵及生活質量的差異。方法：選取2009年5月~2013年2月在我院手術治療的51例AS患者，其中男31例，女20例，年齡21~62歲，平均40.6歲。所有患者均填寫Oswestry功能障礙指數（Oswestry disability index，ODI）、巴氏AS疾病活動指數（Bath ankylosing spondylitis disease activity index，BASDAI）、巴氏AS 功能指數（Bath ankylosing spondylitis functional index，BASFI）、巴氏AS 計量指數（Bath ankylosing spondylitis metrology index，BASMI）、巴氏 AS 總體評分（Bath ankylosing spondylitis global score，BAS-G）、巴氏 AS 放射指數（Bath ankylosing spondylitis radiology index，BASRI）及SF-36量錶；同時記錄其髮病年齡、病程、血沉（erythrocyte sedimentation rate，ESR）、C反應蛋白（C-reactive protein，CRP）、人類白細胞抗原-B27亞型（HLA-B27）；在立位全脊柱側位X線片上測量全脊柱最大後凸角（global kyphosis，GK）、腰椎前凸角（lumbar lordosis，LL）、胸椎後凸角（thoracic kyphosis，TK）、矢狀麵平衡（sagittal vertical axis，SVA）、骨盆投射角（pelvic incidence，PI）、骨盆傾斜角（pelvic tilting，PT）及骶骨傾斜角（sacral slope，SS）。比較男性組與女性組髮病年齡、病程、ESR、CRP、HLA-B27暘性率、TK、GK、LL、SVA、PI、PT、SS、ODI、BASDAI、BASFI、BASMI、BAS-G、BASRI及SF-36量錶各維度之間的差異。結果：男女比例為1.6∶1。與男性組比較，女性組髮病年齡較晚、病程較短、ESR和CRP水平較高及HLA-B27暘性率較低（P<0.05）。與男性組比較，女性組錶現齣較高的ODI、BASDAI、BASRI 評分及較低的BASMI 評分（P<0.05），兩組BASFI及BAS-G無統計學差異（P＞0.05）。脊柱-骨盆矢狀麵參數中，與男性組比較，女性組錶現齣較大的GK、SVA（P<0.05），兩組TK、LL、PI、PT及SS均無統計學差異（P＞0.05）。SF-36量錶各維度中，女性組情感職能得分、精神健康得分低于男性組，而生理功能得分、社會功能得分高于男性組（P<0.05），兩組生理職能、身體疼痛、總體健康狀況及活力得分無統計學差異（P＞0.05）。結論：在行手術治療的AS患者中，男女比例為1.6∶1。與男性AS患者相比，女性患者病情較重，且髮病年齡較晚，病程較短。此外，男性AS患者生理功能、社會功能受到明顯的限製，而女性AS患者情感職能、精神健康受到明顯的損害。
목적：탐토남녀성강직성척주염（ankylosing spondylitis，AS）흉요추후철기형환자림상특정급생활질량적차이。방법：선취2009년5월~2013년2월재아원수술치료적51례AS환자，기중남31례，녀20례，년령21~62세，평균40.6세。소유환자균전사Oswestry공능장애지수（Oswestry disability index，ODI）、파씨AS질병활동지수（Bath ankylosing spondylitis disease activity index，BASDAI）、파씨AS 공능지수（Bath ankylosing spondylitis functional index，BASFI）、파씨AS 계량지수（Bath ankylosing spondylitis metrology index，BASMI）、파씨 AS 총체평분（Bath ankylosing spondylitis global score，BAS-G）、파씨 AS 방사지수（Bath ankylosing spondylitis radiology index，BASRI）급SF-36량표；동시기록기발병년령、병정、혈침（erythrocyte sedimentation rate，ESR）、C반응단백（C-reactive protein，CRP）、인류백세포항원-B27아형（HLA-B27）；재립위전척주측위X선편상측량전척주최대후철각（global kyphosis，GK）、요추전철각（lumbar lordosis，LL）、흉추후철각（thoracic kyphosis，TK）、시상면평형（sagittal vertical axis，SVA）、골분투사각（pelvic incidence，PI）、골분경사각（pelvic tilting，PT）급저골경사각（sacral slope，SS）。비교남성조여녀성조발병년령、병정、ESR、CRP、HLA-B27양성솔、TK、GK、LL、SVA、PI、PT、SS、ODI、BASDAI、BASFI、BASMI、BAS-G、BASRI급SF-36량표각유도지간적차이。결과：남녀비례위1.6∶1。여남성조비교，녀성조발병년령교만、병정교단、ESR화CRP수평교고급HLA-B27양성솔교저（P<0.05）。여남성조비교，녀성조표현출교고적ODI、BASDAI、BASRI 평분급교저적BASMI 평분（P<0.05），량조BASFI급BAS-G무통계학차이（P＞0.05）。척주-골분시상면삼수중，여남성조비교，녀성조표현출교대적GK、SVA（P<0.05），량조TK、LL、PI、PT급SS균무통계학차이（P＞0.05）。SF-36량표각유도중，녀성조정감직능득분、정신건강득분저우남성조，이생리공능득분、사회공능득분고우남성조（P<0.05），량조생리직능、신체동통、총체건강상황급활력득분무통계학차이（P＞0.05）。결론：재행수술치료적AS환자중，남녀비례위1.6∶1。여남성AS환자상비，녀성환자병정교중，차발병년령교만，병정교단。차외，남성AS환자생리공능、사회공능수도명현적한제，이녀성AS환자정감직능、정신건강수도명현적손해。
Objectives: To investigate the differences in ankylosing spondylitis (AS) -related thoracolumbar kyphosis between male and female patients in terms of clinical characteristics and life quality. Methods:From May 2009 to February 2013, 51 AS patients (31 males and 20 females) with an average age of 40.6 years (21-62 years) were included in the study. All patients were completed Oswestry disability index (ODI), Bath ankylosing spondylitis disease activity index(BASDAI), Bath ankylosing spondylitis functional index(BAS-FI), Bath ankylosing spondylitis metrology index (BASMI), Bath ankylosing spondylitis global score (BAS-G), Bath ankylosing spondylitis radiology index (BASRI) and SF-36. Additionally, age at onset, disease duration,erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and HLA-B27 were recorded. Sagittal parameters were measured on standing lateral full-spine radiographs, including thoracic kyphosis(TK), global kyphosis(GK), lumbar lordosis(LL), sagittal vertical axis(SVA), pelvic incidence(PI), pelvic tilting(PT) and sacral slope(SS). A comparison was conducted in terms of age at onset, disease duration, ESR, CRP, HLA-B27, TK, LL, GK, SVA, PI, PT, SS, ODI, BASDAI, BASFI, BASMI, BAS-G, BASRI and SF-36 between male and female patients. Results: The ratio of male/female was 1.6∶1. Compared with male patients, female patients had an older mean age at disease onset, a shorter mean time of disease duration, a higher mean baseline of ESR and CRP and a lower proportion of HLA-B27 positive(P<0.05). Additionally, females had higher ODI, BASAI and BASDRI scores than males; however, females exhibited lower BASMI score (P<0.05). No significant differences were observed in BASFI and BSA-G between the two groups (P>0.05). In sagittal spinopelvic parameters, females had higher GK and SVA(P<0.05), whereas there was no difference in TK, LL, PI, PT or SS between the two groups (P>0.05). With respect to the domains of SF-36, females showed lower role emotional score and mental health score than males; whereas females had higher physical functioning score and social functioning score (P<0.05). No significant differences were noted in role physical, bodily pain, general health and vitality between the two groups (P>0.05). Conclusions: In AS patients requiring surgical correction, the male/female ratio of 1.6∶1 is observed. Compared with male AS patients, female patients have a higher burden of disease and a later disease onset of shorter duration. Moreover, notable limitations of physical functioning and social functioning are found in male AS patients. While obvious damages of role emotional and mental health are observed in females AS patients.