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| 颈椎小关节评估在改良型Stoke强直性脊柱炎脊柱评分体系中对评估强直性脊柱炎的影像学进展的研究 |
| Assessment of the cervical facet joints in the modified Stoke ankylosing spondylitis spine score for the evaluation of spinal radiographic progress in ankylosing spondylitis |
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| DOI：10.3969/j.issn.1006.7108.2018.01.005 |
| 中文关键词: 强直性脊柱炎 脊柱损伤 影像学评估 颈椎小关节 |
| 英文关键词:Ankylosing spondylitis Spinal damage Radiographic assessment Cervical facet joint |
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| 中文摘要: |
| 目的 探讨颈椎小关节评估在改良型Stoke强直性脊柱炎脊柱评分体系(modified Stoke ankylosing spondylitis spine score，mSASSS)中对强直性脊柱炎患者（ankylosing spondylitis，AS）的影像学进展评估的临床诊断价值。方法 收集了我院2010年1月-2014年12月期间收治的65例强直性脊柱炎患者。每个患者在随访前及随访过程中进行脊柱影像学检查，并根据mSASSS评分体系评估患者脊柱椎体的整体情况，以及增加针对颈椎小关节的影像学评估体系，通过计算两部分评分总和，即为我们定义的混合型改良脊柱评分（combined modified AS spine socre，cmASSS），并评价cmASSS评分体系的临床应用价值。结果 在65例AS患者中，其中有58例完成的cmASSS评分。在随访前的影像学检查中通过cmASSS评分体系发现有69.0%的患者存在脊柱损伤的影像学改变，而mSASSS评分体系仅诊断50.0%的患者存在脊柱损伤（P=0.038）。随访观察期内通过影像学对疾病进展评估后发现，cmASSS评分体系中有60.3%的患者存在疾病进展，而mSASSS仅发现41.4%的患者存在疾病进展（P =0.041）。根据斯皮尔曼等级相关分析，cmASSS评分与AS患者的颈椎旋转、枕墙距、脊柱侧弯、胸廓扩张等脊柱活动度指标和AS功能指数的相关性优于mSASSS评分。结论 在mSASSS基础上整合颈椎小关节评估有助于更全面、及时地诊断AS患者的脊柱损伤情况和脊柱损伤进展或转归，为AS的治疗、预后评估提供指导。 |
| 英文摘要: |
| Objective To explore the clinical value of the assessment of the cervical facet joint score in the modified Stoke ankylosing spondylitis spine score (mSASSS) for the spinal radiographic progress in ankylosing spondylitis (AS) patients. Methods 65 cases of AS patients were collected from our hospital from January 2010 to December 2014. All the patients underwent the radiographic image examination at the baseline time and during the follow up. The vertebral bodies were assessed according to mSASSS and the cervical facet joints were assessed additionally. The sum of both scorers was defined as combined modified AS spine score (cmASSS). The clinical value of cmASSS system was evaluated. Results 58 cases in 65 AS patients had completed the cmASSS. At the baseline time, 69.0% patients were defined as spinal damage with cmASSS, which was more than 50.0% with mSASSS (P =0.038). During the follow up, there was 60.3% patients was defined with radiographic progress by cmASSS, but only 41.4% patients was found with radiographic progress by mSASSS (P =0.041). By Spearman rank correlation analysis, cervical rotation, occiput to wall distance, lateral spinal flexion, chest expansion, and AS functional index were correlated better with cmASSS than with mSASSS. Conclusion Integration of the assessment the of cervical facet joints and mSASSS benefits comprehensive and timely diagnosis of AS spinal damage and progress, and provides an indicator for AS treatment and prognosis. |
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