脊椎关节炎诊断延迟的全球模式和决定因素:来自ASAS-PerSpA国际研究的见解
Maroun Aoun1, Sherif M Gamal2, Ihsane Hmamouchi3
1Medicine Department, Saint-Joseph University, Beirut, Lebanon.
Rheumatology (Oxford, England)
|September 26, 2025
概括
在脊椎关节炎 (SpA) 中的诊断延迟 (DD) 在轴性SpA (axSpA) 和炎症性肠病相关的SpA (IBD-SpA) 中更长,当症状从轴开始时. 考虑到最初的呈现是理解SpA诊断延迟的关键.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 临床医学 临床医学
背景情况:
- 诊断延迟 (DD) 是脊椎关节炎 (SpA) 的一个重要问题,特别是在轴性疾病中.
- 了解不同SPA实体和初始症状的DD对于及时诊断至关重要.
研究的目的:
- 根据初始呈现,估计各种SPA实体的DD.
- 为了确定与不同SpA亚型中DD相关的因素.
主要方法:
- 对4339名SPA患者的分析,包括轴向性 (axSpA),外围性 (pSpA),牛皮关节炎 (PsA) 和IBD-SpA.
- 使用两个定义来评估DD:包括肌肉骨外表现 (EMM) 或仅关注肌肉骨表现 (MMs).
- 多变量线性回归用于评估 axSpA,PsA,pSpA 和 IBD-SpA 中与 DD 相关的因素.
主要成果:
- 当仅考虑MM (4.5年) 和包括EMM (6.6年) 时,平均DD较短.
- 当初MM是轴向 (分别为5.6年和5.2年) 时,axSpA和IBD-SpA的DD显著更长,而不是PsA和pSpA (2.5年和3.1年).
- 与较长DD相关的因素包括轴性第一个表现,症状发作时的年龄较小,在研究纳入时的年龄较大.
结论:
- 在SpA中DD因疾病实体和初始症状的性质而有显著差异.
- AxSpA和IBD-SpA表现出更长的诊断延迟,特别是当轴性症状首先出现时.
- 在SpA中对DD的临床报告应考虑特定的SpA类型和呈现的表型.
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