来源：风湿病与关节炎,2019,8（3）:28-32.

移动医疗模式在强直性脊柱炎患者诊疗中的临床意义初探（临床研究）

周　瀛，刘梦洁，潘新兰，谢长好，李志军

　　【摘　要】目的：探讨移动医疗模式在强直性脊柱炎患者诊疗过程中的临床意义。方法：分析2017年1月至2018年3月就诊于蚌埠医学院第一附属医院风湿免疫科的强直性脊柱炎患者190例，根据患者意愿分为移动医疗组128例和传统医疗组62例，收集基线及随访时的临床资料，分析临床指标的变化，并评估治疗依从性对疾病的影响。结果：①移动医疗组患者年龄较小，病程较短，红细胞沉降率（ESR）、C-反应蛋白（CRP）、强直性脊柱炎疾病活动评分（ASDAS）较高；②移动医疗组患者自行停药减药发生率（24.22%）较传统治疗组（38.71%）低；患者症状控制不佳或缓解再次加重发生率（35.94%）较传统治疗组（48.39%）低；③随访时移动医疗组患者强直性脊柱炎测量指数（BASMI）评分、强直性脊柱炎功能指数（BASFI）评分较基线时升高，患者评分、ESR、CRP及ASDAS降低。结论：移动医疗模式可以提高强直性脊柱炎患者的治疗依从性和规范性，间接提高治疗效果。

　　【关键词】　脊柱炎，强直性；移动医疗模式；依从性；疗效

Clinical Significance of Mobile Medical Model in Diagnosis and Treatment of Ankylosing Spondylitis

ZHOU Ying,LIU Meng-jie,PAN Xin-lan,XIE Chang-hao,LI Zhi-jun

　　【ABSTRACT】Objective:To explore the clinical significance of mobile medical model in the diagnosis and treatment of ankylosing spondylitis.Methods:One hundred and ninety cases with Ankylosing Spondylitis treated in the Department of Rheumatology and Immunology of the First Affiliated Hospital of Bengbu Medical College from January 2017 to March 2018 were analyzed.They were divided into the mobile medical group（128 cases）and the traditional medical group（62 cases）according to their wishes.The clinical data at baseline and follow-up were collected,the changes of clinical indicators were analyzed,and the influence of treatment compliance on the disease was evaluated.Results:①Patients in the mobile medical group were younger with shorter course of disease,and their ESR,CRP and ASDAS were higher;②In the mobile medical group,fewer incidences happened about self-withdrawal and drug reduction（24.22%）than the traditional treatment group（38.71%）;the incidence of poor control of symptom or aggravation after remission（35.94%）was lower than that of the traditional treatment group（48.39%）;③At the follow-up,BASMI and BASFI scores in the mobile medical group were higher than those at the baseline,while patients’ scores,and the scores of ESR,CRP and ASDAS were lower.Conclusion:Mobile medical model can improve the treatment compliance and standardization for patients with ankylosing spondylitis,and indirectly improve the treatment effect.

　　【Keywords】 spondylitis,ankylosing;mobile medical model;compliance;curative effect