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Rheumatology (Oxford). 2010 Jan;49(1):73-81. Epub 2009 Jul 14. Hip involvement in ankylosing spondylitis: epidemiology and risk factors associated with hip replacement surgery. Vander Cruyssen B, Muñoz-Gomariz E, Font P, Mulero J, de Vlam K, Boonen A, Vazquez-Mellado J, Flores D, Vastesaeger N, Collantes E; ASPECT-REGISPONSER-RESPONDIA working group. Department of Rheumatology, Ghent University Hospital, B-9000 Gent, Belgium. bert.vandercruyssen@ugent.be Abstract OBJECTIVES: Although clinicians recognize hip involvement, which frequently leads to hip replacement surgery, as an important feature of AS, data on the epidemiology, nature of the disease and therapeutic strategies are scarce. We aimed to describe the epidemiology of clinical and radiological hip involvement and define the risk factors for the hip replacement surgery in AS patients. METHODS: Data from 3 datasets were merged, including 847 Belgian (ASPECT database), 1405 Spanish (REGISPONSER database) and 466 Ibero-American (RESPONDIA database) AS patients. The ASPECT and REGISPONSER database (Dataset A) are used for exploratory analysis; the RESPONDIA database (Dataset B) is used for confirmative analysis. Factors associated with hip involvement and the hip replacement surgery were analysed. RESULTS: Twenty four (REGISPONSER) to 36% (RESPONDIA) of AS patients under rheumatologist's care presented clinical hip involvement, including the 5% (Dataset A) of AS patients who needed hip replacement surgery. Patients with hip involvement had significantly worse overall Bath Ankylosing Spondylitis Functional Index (BASFI) scores compared with patients without hip involvement (mean difference = 1.6, P < 0.001) (Dataset A, confirmed in B). Corrected for disease duration, patients with early disease onset, enthesial and axial disease needed most frequently hip replacement surgery (Dataset A, confirmed in B). CONCLUSION: Hip involvement is commonly recognized by rheumatologists in AS patients, and involves about one out of the three to four patients with AS and is associated with impaired functioning reflected by higher overall BASFI scores. Early onset of disease, axial and enthesial disease are associated with the hip replacement surgery in AS.
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强直性脊柱炎中的髋关节受累：流行病学和髋关节置换术的相关危险因素 Cruyssen V, et al.Rheumatology (Oxford). 2010 Jan;49(1):73-81. 目的：尽管临床医师已经认识到髋关节受累是强直性脊柱炎(AS)重要的临床表现，常需要进行髋关节置换术，但鲜有关于其流行病学、自然病程和治疗方案的资料。本文旨在了解AS患者临床及影像学髋关节受累的流行病学，明确髋关节置换术的危险因素。 方法：从3个数据库采集相关资料，包括847例比利时AS患者（ASPECT数据库）、1405例西班牙患者（REGISPONSER数据库）和466例伊比利亚美洲患者（RESPONDIA数据库）。ASPECT和REGISPONSER数据库（A数据组）用于探索性分析；RESPONDIA数据库（B数据组）用于验证性分析。分析髋关节受累和髋关节置换术的相关危险因素。 结果：24%（REGISPONSER）~36%（RESPONDIA）AS患者出现临床髋关节受累，5%（A数据组）AS患者需要进行髋关节置换术。有髋关节受累的患者总体Bath强直性脊柱炎功能指数（BASFI）显著差于没有髋关节受累的患者（平均差值为1.6，P < 0.001）（A数据组，在B数据组验证）。校正病程后，早发病、附着点炎和中轴型患者最常需要髋关节置换术（A数据组，在B数据组验证）。 结论：风湿科医生发现约1/4~1/3 AS患者有髋关节受累，其与功能受损相关，表现为总体BASFI积分更高。早发病、中轴疾病和附着点炎与髋关节置换术相关。 |