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临床和成像发现肠道病性脊柱关节炎,特别强调诊断延迟:一个横截面研究
Paola Conigliaro1, Arianna D'Antonio2, Andrea Wlderk3
1Rheumatology, Allergology and Clinical Immunology, Department of "Medicina dei Sistemi", University of Rome Tor Vergata, Via Montpellier 1, Rome 00133, Italy.
肠病性脊柱性关节炎 (eSpA) 诊断往往会延迟,特别是在放射性轴性SpA (r-axSpA) 和非放射性axSpA (nr-axSpA) 之间. 人口和放射学因素显著影响着炎症性肠病患者的诊断延迟.
科学领域:
- 类风湿病学 类风湿病学
- 胃肠病学 胃肠病学
- 炎症性肠病 (IBD) 是一种炎症性肠病.
背景情况:
- 肠病性脊髓关节炎 (eSpA) 是一种与炎症性肠病 (IBD) 相关的慢性炎症性关节疾病.
- 由于药物掩盖疾病活动,IBD患者的关节炎往往被低估,导致潜在的诊断延迟.
研究的目的:
- 为了评估eSpA的诊断延迟.
- 探索与eSpA.诊断延迟相关的人口,临床和放射学因素.
主要方法:
- 一个单中心的横截面研究,连续的门诊患者被转诊到综合胃肠病学-风湿病学 (Gi-Rhe) 诊所.
- 对190名eSpA患者的分析,包括外围Spa,轴向Spa (AxSpA) 和非放射性axSpA (nr-axSpA).
- 评估诊断延迟,疾病活性,炎症标志物,常规放射 (CR) 和关节/脊柱的MRI.
主要成果:
- 在eSpA中,诊断延迟的中位数为48个月,轴向和外围SpA之间没有差异.
- 放射性-axSpA (r-axSpA) 患者的诊断延迟比nr-axSpA患者更高.
- 与诊断延迟增加相关的因素包括男性性别,特定的放射性病变 (硬化症,综合细胞,桥梁),更长的疾病持续时间,牛皮和MRI检测到的骨质侵蚀.
结论:
- 在eSpA的诊断延迟显著,并且在r-axSpA中比nr-axSpA更高,无论治疗方式如何.
- 人口特征,临床特征和放射学发现与eSpA的诊断延迟有关.
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