{"title":"[疾病活动度低的轴性脊柱关节炎患者残余症状评估及其相关因素分析]。","authors":"Jiayu Zhai, Jinxia Zhao, Zhuo An, Rui Liu","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To comprehensively assess the occurrence of residual symptoms in patients with axial spondyloarthritis who have successfully attained the treatment goal of low disease activity, and to conduct a thorough analysis of the related factors.</p><p><strong>Methods: </strong>An analysis was performed on axial spondyloarthritis patients who achieved low disease activity for the first time during their visits at the Rheumatology and Immunology Department of Peking University Third Hospital, spanning from May 1, 2021, to February 29, 2024. Based on the ankylosing spondylitis disease activity score-C-reactive protein (ASDAS-CRP), the patients who achieved low disease activity were divided into a non-remission low disease activity group and a remission group. The occurrence of residual fatigue and pain symptoms in both groups was assessed, and binary Logistic regression analysis was used to evaluate the related factors.</p><p><strong>Results: </strong>In the study, 201 patients achieved low disease activity during treatment. The gender distribution was skewed towards males, with 151 male patients (75.1%) and 50 female patients (24.9%). The median age of the patients who achieved low disease activity was 32.0 (28.0, 37.0) years, and the median disease duration was 6.7 (3.8, 11.5) years. Notably, 140 patients (69.7%) achieved low disease activity but did not experience complete remission, while 61 patients (30.3%) attained remission. A substantial proportion of the patients, 45.8%, reported residual fatigue visual analogue scale (VAS) ≥4, with a marked difference between the non-remission low disease activity group and the remission group (53.6% <i>vs</i>. 27.9%, <i>P</i>=0.001). Similarly, 24.4% of the patients had residual pain VAS ≥4, with a significant disparity between the non-remission low disease activity group and the remission group (30.0% <i>vs</i>. 11.5%, <i>P</i>=0.005). Binary Logistic regression analysis revealed that C-reactive protein levels had a notable negative influence on residual fatigue symptom (<i>B</i>=-0.142, <i>P</i>=0.008, <i>OR</i>=0.868), whereas ASAS-HI had a positive effect on residual fatigue (<i>B</i>=0.288, <i>P</i> < 0.001, <i>OR</i>=1.334). Gender was found to have a significant impact on residual pain symptoms, with females exhibiting a higher risk (<i>B</i>=1.135, <i>P</i>=0.002, <i>OR</i>=3.112).</p><p><strong>Conclusion: </strong>The residual fatigue and pain symptoms are common in axial spondyloarthritis patients who have achieved low disease activity, particularly among female patients. More assessment and recognition of the residual disease burden in these patients will be needed to optimize the treatment strategies.</p>","PeriodicalId":8790,"journal":{"name":"北京大学学报(医学版)","volume":"56 6","pages":"987-993"},"PeriodicalIF":0.0000,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652986/pdf/","citationCount":"0","resultStr":"{\"title\":\"[Assessment of residual symptoms in patients with axial spondyloarthritis with low disease activity and analysis of its related factors].\",\"authors\":\"Jiayu Zhai, Jinxia Zhao, Zhuo An, Rui Liu\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To comprehensively assess the occurrence of residual symptoms in patients with axial spondyloarthritis who have successfully attained the treatment goal of low disease activity, and to conduct a thorough analysis of the related factors.</p><p><strong>Methods: </strong>An analysis was performed on axial spondyloarthritis patients who achieved low disease activity for the first time during their visits at the Rheumatology and Immunology Department of Peking University Third Hospital, spanning from May 1, 2021, to February 29, 2024. Based on the ankylosing spondylitis disease activity score-C-reactive protein (ASDAS-CRP), the patients who achieved low disease activity were divided into a non-remission low disease activity group and a remission group. The occurrence of residual fatigue and pain symptoms in both groups was assessed, and binary Logistic regression analysis was used to evaluate the related factors.</p><p><strong>Results: </strong>In the study, 201 patients achieved low disease activity during treatment. The gender distribution was skewed towards males, with 151 male patients (75.1%) and 50 female patients (24.9%). The median age of the patients who achieved low disease activity was 32.0 (28.0, 37.0) years, and the median disease duration was 6.7 (3.8, 11.5) years. Notably, 140 patients (69.7%) achieved low disease activity but did not experience complete remission, while 61 patients (30.3%) attained remission. A substantial proportion of the patients, 45.8%, reported residual fatigue visual analogue scale (VAS) ≥4, with a marked difference between the non-remission low disease activity group and the remission group (53.6% <i>vs</i>. 27.9%, <i>P</i>=0.001). Similarly, 24.4% of the patients had residual pain VAS ≥4, with a significant disparity between the non-remission low disease activity group and the remission group (30.0% <i>vs</i>. 11.5%, <i>P</i>=0.005). Binary Logistic regression analysis revealed that C-reactive protein levels had a notable negative influence on residual fatigue symptom (<i>B</i>=-0.142, <i>P</i>=0.008, <i>OR</i>=0.868), whereas ASAS-HI had a positive effect on residual fatigue (<i>B</i>=0.288, <i>P</i> < 0.001, <i>OR</i>=1.334). Gender was found to have a significant impact on residual pain symptoms, with females exhibiting a higher risk (<i>B</i>=1.135, <i>P</i>=0.002, <i>OR</i>=3.112).</p><p><strong>Conclusion: </strong>The residual fatigue and pain symptoms are common in axial spondyloarthritis patients who have achieved low disease activity, particularly among female patients. More assessment and recognition of the residual disease burden in these patients will be needed to optimize the treatment strategies.</p>\",\"PeriodicalId\":8790,\"journal\":{\"name\":\"北京大学学报(医学版)\",\"volume\":\"56 6\",\"pages\":\"987-993\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-12-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11652986/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"北京大学学报(医学版)\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"北京大学学报(医学版)","FirstCategoryId":"3","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
摘要
目的:综合评价已成功达到低疾病活动度治疗目标的中轴性脊柱炎患者残留症状的发生情况,并对相关因素进行深入分析。方法:对2021年5月1日至2024年2月29日在北京大学第三医院风湿病免疫科就诊期间首次达到低疾病活动度的轴型脊柱炎患者进行分析。根据强直性脊柱炎疾病活动性评分- c反应蛋白(ASDAS-CRP),将达到低疾病活动性的患者分为非缓解性低疾病活动性组和缓解组。评估两组患者残余疲劳和疼痛症状的发生情况,并采用二元Logistic回归分析评价相关因素。结果:在研究中,201例患者在治疗期间达到低疾病活动度。性别分布以男性为主,男性151例(75.1%),女性50例(24.9%)。低疾病活动度患者的中位年龄为32.0(28.0,37.0)岁,中位病程为6.7(3.8,11.5)年。值得注意的是,140名患者(69.7%)达到了低疾病活动度,但没有完全缓解,而61名患者(30.3%)达到了缓解。45.8%的患者报告剩余疲劳视觉模拟量表(VAS)≥4,非缓解低疾病活动性组和缓解组之间存在显著差异(53.6% vs. 27.9%, P=0.001)。同样,24.4%的患者残留疼痛VAS≥4,非缓解低疾病活动度组与缓解组之间差异显著(30.0% vs 11.5%, P=0.005)。二元Logistic回归分析显示,c反应蛋白水平对剩余疲劳症状有显著的负向影响(B=-0.142, P=0.008, OR=0.868),而ASAS-HI水平对剩余疲劳症状有显著的正向影响(B=0.288, P < 0.001, OR=1.334)。性别对残留疼痛症状有显著影响,女性表现出更高的风险(B=1.135, P=0.002, OR=3.112)。结论:在疾病活动度较低的中轴性脊柱炎患者中,残余疲劳和疼痛症状是常见的,尤其是女性患者。需要对这些患者的残留疾病负担进行更多的评估和认识,以优化治疗策略。
[Assessment of residual symptoms in patients with axial spondyloarthritis with low disease activity and analysis of its related factors].
Objective: To comprehensively assess the occurrence of residual symptoms in patients with axial spondyloarthritis who have successfully attained the treatment goal of low disease activity, and to conduct a thorough analysis of the related factors.
Methods: An analysis was performed on axial spondyloarthritis patients who achieved low disease activity for the first time during their visits at the Rheumatology and Immunology Department of Peking University Third Hospital, spanning from May 1, 2021, to February 29, 2024. Based on the ankylosing spondylitis disease activity score-C-reactive protein (ASDAS-CRP), the patients who achieved low disease activity were divided into a non-remission low disease activity group and a remission group. The occurrence of residual fatigue and pain symptoms in both groups was assessed, and binary Logistic regression analysis was used to evaluate the related factors.
Results: In the study, 201 patients achieved low disease activity during treatment. The gender distribution was skewed towards males, with 151 male patients (75.1%) and 50 female patients (24.9%). The median age of the patients who achieved low disease activity was 32.0 (28.0, 37.0) years, and the median disease duration was 6.7 (3.8, 11.5) years. Notably, 140 patients (69.7%) achieved low disease activity but did not experience complete remission, while 61 patients (30.3%) attained remission. A substantial proportion of the patients, 45.8%, reported residual fatigue visual analogue scale (VAS) ≥4, with a marked difference between the non-remission low disease activity group and the remission group (53.6% vs. 27.9%, P=0.001). Similarly, 24.4% of the patients had residual pain VAS ≥4, with a significant disparity between the non-remission low disease activity group and the remission group (30.0% vs. 11.5%, P=0.005). Binary Logistic regression analysis revealed that C-reactive protein levels had a notable negative influence on residual fatigue symptom (B=-0.142, P=0.008, OR=0.868), whereas ASAS-HI had a positive effect on residual fatigue (B=0.288, P < 0.001, OR=1.334). Gender was found to have a significant impact on residual pain symptoms, with females exhibiting a higher risk (B=1.135, P=0.002, OR=3.112).
Conclusion: The residual fatigue and pain symptoms are common in axial spondyloarthritis patients who have achieved low disease activity, particularly among female patients. More assessment and recognition of the residual disease burden in these patients will be needed to optimize the treatment strategies.
期刊介绍:
Beijing Da Xue Xue Bao Yi Xue Ban / Journal of Peking University (Health Sciences), established in 1959, is a national academic journal sponsored by Peking University, and its former name is Journal of Beijing Medical University. The coverage of the Journal includes basic medical sciences, clinical medicine, oral medicine, surgery, public health and epidemiology, pharmacology and pharmacy. Over the last few years, the Journal has published articles and reports covering major topics in the different special issues (e.g. research on disease genome, theory of drug withdrawal, mechanism and prevention of cardiovascular and cerebrovascular diseases, stomatology, orthopaedic, public health, urology and reproductive medicine). All the topics involve latest advances in medical sciences, hot topics in specific specialties, and prevention and treatment of major diseases.
The Journal has been indexed and abstracted by PubMed Central (PMC), MEDLINE/PubMed, EBSCO, Embase, Scopus, Chemical Abstracts (CA), Western Pacific Region Index Medicus (WPR), JSTChina, and almost all the Chinese sciences and technical index systems, including Chinese Science and Technology Paper Citation Database (CSTPCD), Chinese Science Citation Database (CSCD), China BioMedical Bibliographic Database (CBM), CMCI, Chinese Biological Abstracts, China National Academic Magazine Data-Base (CNKI), Wanfang Data (ChinaInfo), etc.