在轴性脊柱关节炎中的残留疾病. 事实和问题的事实和问题
Daniel Wendling1, Philippe Goupille2, Frank Verhoeven1
1Rheumatology Department, CHU de Besançon, University of Franche-Comté, boulevard Fleming, 25030 Besançon cedex, France.
Joint bone spine
|July 3, 2025
概括
轴性脊柱关节炎 (axSpA) 中的残留疾病尽管得到治疗,但仍然存在,通常涉及疼痛和疲劳. 了解像中央敏感性这样的促成因素是有效管理难以治疗的axSpA的关键.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 疼痛医学 医学 疼痛医学
背景情况:
- 轴性脊柱关节炎 (axSpA) 中的残留疾病被定义为持续的迹象,症状或疾病负担,尽管积极治疗.
- 磁共振成像 (MRI) 可能在临床缓解的三分之一的患者中显示炎症.
- 疼痛和疲劳等残留症状在低疾病活性 (LDA) axSpA中很常见,影响20-40%的患者.
研究的目的:
- 在 axSpA 中定义残留疾病并确定相关因素.
- 突出全面患者评估和疼痛机制评估的重要性.
- 强调需要针对难以管理的 (D2M) axSpA进行量身定制的管理策略.
主要方法:
- 审查当前文献和 axSpA.残留疾病的临床定义.
- 促成因素的分析,包括鼻膜性疼痛,神经病痛,女性性别,精神行为障碍,体力活动,肉症,睡眠障碍和并发性疾病.
- 评估当前的管理策略,包括非药理学方法和疾病修饰性抗风湿药物 (DMARDs).
主要成果:
- 剩余症状经常与鼻膜性疼痛 (中心敏感) 和神经病痛组成部分有关.
- 诸如女性性别,精神行为障碍,体力活动低,肉症,睡眠障碍和并发症等因素有助于残留疾病.
- 某些DMARD可能独立于抗炎作用而影响疼痛.
结论:
- 识别残留疾病及其多方面的贡献者对于管理axSpA至关重要,尤其是在没有客观炎症的情况下.
- 全面的患者评估和理解疼痛机制对于有效的管理至关重要.
- 需要新的生物标志物来更好地评估axSpA.中的炎症过程和治疗反应.
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