来源：风湿病与关节炎,2023,12（9）:11-16.

强直性脊柱炎患者达标治疗中影响生活质量的因素及分析（临床研究）

田丹丹^1,2，王善萍²，杨　丽²，张婷婷²，何　丽²，刘天阳²，管玉香²，黄传兵²

　　【摘　要】目的：研究强直性脊柱炎患者达标治疗中影响生活质量的因素并分析其原因，为强直性脊柱炎临床诊治提供依据。方法：选取2018年6月至2021年7月在安徽中医药大学第一附属医院风湿科住院的105例强直性脊柱炎患者，采用单因素、关联规则、Spearman相关及Logistic回归分析强直性脊柱炎患者达标治疗中焦虑、抑郁发生情况及相关因素。结果：105例强直性脊柱炎患者中，焦虑发生率为40.95%，抑郁发生率为37.14%，焦虑合并抑郁发生率为31.43%。单因素分析显示，焦虑组、抑郁组病程、脊柱痛评分、强直性脊柱炎疾病活动评分（ASDAS）、红细胞沉降率（ESR）、C反应蛋白（CRP）显著高于非焦虑组、非抑郁组（P < 0.01）；焦虑抑郁组病程、脊柱痛评分、ASDAS、ESR、CRP显著高于非焦虑抑郁组（P < 0.01）。关联规则模型分析发现，SDS、SAS评分与ESR、CRP、ASDAS、脊柱痛、病程、家庭月收入、医保、住院次数、婚姻状况因素呈复杂的网络关系。Spearman相关性分析显示，SAS、SDS评分与病程、脊柱痛、ASDAS及ESR呈正相关（P < 0.01）。Logistic回归分析显示，病程、住院次数、脊柱痛、ASDAS、ESR是焦虑合并抑郁的独立危险因素（P < 0.05），其中ASDAS是最大危险因素（P < 0.05）。结论：强直性脊柱炎患者达标治疗中影响生活质量的因素主要有病程、经济状况、疾病活动度和炎症指标，其中疾病活动度为高危因素。

　　【关键词】　强直性脊柱炎；达标治疗；生活质量；影响因素

Analysis of Factors Affecting Quality of Life in Standard Treatment for Patients with Ankylosing Spondylitis

TIAN Dan-dan,WANG Shan-ping,YANG Li,ZHANG Ting-ting,HE Li,LIU Tian-yang,GUAN Yu-xiang,HUANG Chuan-bing

　　【ABSTRACT】Objective:To study the factors that affect the quality of life in patients with ankylosing spondylitis during standard treatment and analyze their causes,in order to provide a basis for clinical diagnosis and treatment of ankylosing spondylitis.Methods:One hundred and five patients with ankylosing spondylitis who were hospitalized in the Rheumatology Department of the First Affiliated Hospital of Anhui University of Chinese Medicine from June 2018 to July 2021 were selected.The incidence of anxiety and depression in ankylosing spondylitis patients during standard treatment was analyzed using univariate analysis,association rules,Spearman correlation,and logistic regression analysis.Results:Among 105 patients with ankylosing spondylitis,the incidence of anxiety was 40.95%,the incidence of depression was 37.14%,and the incidence of anxiety combined with depression was 31.43%.Univariate analysis showed that the course of disease,spinal pain score,ankylosing spondylitis disease activity score（ASDAS）,erythrocyte sedimentation rate（ESR）,and C-reactive protein（CRP）in the anxiety and depression group were significantly higher than those in the non-anxiety and non-depression groups（P < 0.01）;the age,course of disease,spinal pain score,ASDAS,ESR,and CRP of the anxiety and depression group were significantly higher than those of the non anxiety and depression group（P < 0.01）.Establishing an association rule model analysis found that SDS and SAS scores exhibit complex network relationships with ESR,CRP,ASDAS,spinal pain,course of disease,monthly family income,medical insurance,hospitalization frequency,and marital status factors.Spearman correlation analysis showed that SAS and SDS scores were positively correlated with disease course,spinal pain,and ESR（P < 0.01）.The results of logistic regression analysis showed that disease course,hospitalization frequency,spinal pain,ASDAS,and ESR were independent risk factors for anxiety and depression（P < 0.05）,with ASDAS being the largest risk factor（P < 0.05）.Conclusion:The factors that affect the quality of life in patients with ankylosing spondylitis during standard treatment mainly include course of disease,economic status,disease activity,and inflammatory indicators,with disease activity being a high-risk factor.

　　【Keywords】 ankylosing spondylitis;standard treatment;quality of life;influence factor