应用SF36量表评估中轴型SpA患者非甾体抗炎药治疗前后生活质量变化

发布时间：2019-06-26 18:36

【摘要】：目的比较两种非甾体抗炎药(NSAIDs)治疗中轴型脊柱关节炎(中轴型SpA)的疗效有无差异,并应用36条简明健康状况调查量表(SF36量表)评价治疗前后中轴型SpA患者的生活质量。方法选择2014年10月—2015年9月在郑州大学第一附属医院确诊为中轴型SpA的患者120例。均同意使用指定药物及指定量表评估,并签署知情同意书。采用随机、双盲、平行对照的方法,通过单纯随机分组,将120人分为艾瑞昔布组和塞来昔布组,均为每次200mg,每天两次,治疗3个月。采用中文版SF36量表评估中轴型SPA患者NSAIDs治疗前后的生活质量变化情况。分析生活质量和血沉(ESR)、C反应蛋白(CRP)、Bath AS疾病活动指数(BASDAI)、Bath强直性脊柱炎功能指数(BASFI)、加拿大脊柱关节炎研究协会评分(SPARCC)之间的相关性。结果中轴型SpA患者116人完成最终评估,4人失访。应用SF36量表评估中轴型SpA患者NSAIDs治疗3个月治疗前后生活质量变化,两种药物治疗效果的对比差异无统计学意义(P0.05)。总体病人NSAIDs治疗3个月后,生理功能、生理职能、躯体疼痛、总体健康、社会功能、情感职能差异有统计学意义(t值分别为3.004、5.243、5.989、3.858、2.145、3.960,P0.05);活力、精神健康,差异无统计学意义(t值分别为1.784、1.507,P0.05)。BASDAI与PF、RP、BP、GH、VT、SF、RE呈正相关(r值分别为0.406、0.321、0.463、0.347、0.199、0.276、0.340,P0.05);BASDAI与MH无明显相关性(P0.05);BASFI与PF、RP、BP、GH、SF、RE、MH呈正相关(0.523、0.384、0.329、0.193、0.367、0.242、0.214,P0.05);BASFI与VT无明显相关性(P0.05)。患者总体评估与PF、RP、BP、GH、SF、RE、MH呈正相关(P0.05);ESR只与SF、RE呈正相关(P0.05);CRP只与SF、MH呈正相关(P0.05);SPARCC只与PF呈正相关(P0.05);耳壁距只与PF、GH呈正相关(P0.05);腰椎活动度只与SF呈正相关(P0.05);前指地距只与SF呈正相关(P0.05);踝间距只与PF、BP、SF、RE呈正相关(P0.05)。BASDAI、BASFI是影响PF的重要影响因素(P0.05);BASDAI是影响BP、GH、VT、RE的重要影响因素(P0.05);BASFI是影响RP、SF、MH的重要影响因素(P0.05)。结论1.非甾体抗炎药具有改善中轴型SpA患者的生活质量的作用,艾瑞昔布和塞来昔布疗效相当;2.SF36量表可以反应中轴型SpA患者的生活质量的变化,可用于评估中轴型SpA患者治疗前后生活质量的变化。
[Abstract]:Objective to compare the efficacy of two non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of axial spinal arthritis (SpA), and to evaluate the quality of life (QOL) of patients with axial SpA before and after treatment with 36 concise health status scale (SF36). Methods from October 2014 to September 2015, 120 patients with axial SpA diagnosed in the first affiliated Hospital of Zhengzhou University were selected. Agree to the use of designated drugs and designated scales for evaluation, and sign informed consent form. Using the method of random, double blind and parallel control, 120 people were randomly divided into two groups: irixib group and celecoxib group, each time 200mg, twice a day for 3 months. The Chinese version SF36 scale was used to evaluate the changes of quality of life (QOL) in patients with axial SPA before and after NSAIDs treatment. To analyze the correlation between quality of life and erythrocyte sedimentation rate (ESR), C reactive protein (CRP), Bath AS disease activity index (BASDAI), Bath ankylosing spondylitis function index (BASFI), Canadian spinal arthritis research association score (SPARCC). Results the final evaluation was completed in 116 patients with axial SpA and 4 patients lost their follow-up. SF 36 scale was used to evaluate the quality of life (QOL) of patients with axial SpA before and after NSAIDs treatment for 3 months. There was no significant difference between the two drugs (P 0.05). After 3 months of NSAIDs treatment, there were significant differences in physiological function, physical pain, overall health, social function and emotional function (t = 3.004, 5.243, 5.989, 3.858, 2.145, 3.960, P 0.05). There was no significant difference in vitality and mental health (t = 1.784, 1.507, P 0.05). There was a positive correlation between BASDAI and PF,RP,BP,GH,VT,SF,RE (r = 0.406, 0.321, 0.347, 0.199, 0.276, 0.340, P 0.05). There was no significant correlation between); BASDAI and MH (P 0.05), and there was no significant correlation between BASDAI and BASDAI (r = 0.406, 0.321, 0.347, 0.199, 0.276, 0.340, P 0.05). There was a positive correlation between BASFI and PF,RP,BP,GH,SF,RE,MH (0.523, 0.384, 0.329, 0.193, 0.367, 0.242, 0.214, P 0.05). There was no significant correlation between); BASFI and VT (P 0.05). The overall evaluation of the patients was positively correlated with PF,RP,BP,GH,SF,RE,MH (P 0.05); ESR was only positively correlated with SF,RE (P 0.05); CRP was only positively correlated with SF,MH (P 0.05); ear wall distance was only positively correlated with PF,GH (P 0.05); lumbar mobility was only positively correlated with SF (P 0.05); anterior finger distance was only positively correlated with SF (P 0.05). Ankle spacing was only positively correlated with PF,BP,SF,RE (P 0.05). BASDAI and BASFI were important factors affecting PF (P 0.05); BASDAI was an important factor affecting BP,GH,VT,RE (P 0.05); BASFI was an important factor affecting RP,SF,MH (P 0.05). Conclusion 1. Non-steroidal anti-inflammatory drugs can improve the quality of life of patients with axial SpA, and the efficacy of irixib and celecoxib is the same. 2.SF36 scale can reflect the changes of quality of life in patients with axial SpA and can be used to evaluate the changes of quality of life in patients with axial SpA before and after treatment.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R593.23

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