广西医学

目的探讨强直性脊柱炎（AS）并发高尿酸血症患者的临床特征。方法回顾性分析169例AS患者的临床资料，根据患者是否合并高尿酸血症分为高尿酸血症组和尿酸正常组。采用强直性脊柱炎病情活动度（ASDAS⁃CRP或ASDAS⁃ESR）评分、Bath强直性脊柱炎病情活动指数（BASDAI）评分、Bath强直性脊柱炎功能指数（BASFI）评分评估患者的疾病进展情况，采用骶髂关节炎分级情况、加拿大脊柱关节炎研究联盟（SPARCC）骶髂关节炎症评分及SPARCC骶髂关节结构评分（SPARCC⁃SSS）评估患者的骶髂关节炎症和结构性损伤。比较两组患者的临床资料、实验室指标、疾病活动度及骶髂关节炎症和结构性损伤，并分析患者血尿酸水平与疾病严重程度的相关性。结果 169例患者中，38例（22.49%）患者并发高尿酸血症。高尿酸血症组患者的年龄、血清总蛋白水平低于尿酸正常组，男性占比、红细胞计数及血清肌酐水平高于尿酸正常组（P<0.05）。高尿酸血症组患者的BASDAI评分低于尿酸正常组（P<0.05），但两组患者的骶髂关节炎分级情况、SPARCC骶髂关节炎症评分、SPARCC⁃SSS评分、ASDAS⁃CRP评分、ASDAS⁃ESR评分、BASFI评分比较，差异无统计学意义（P>0.05）。相关性分析结果显示，AS患者的血尿酸水平与BASDAI评分呈负相关（P<0.05），与ASDAS⁃CRP评分、ASDAS⁃ESR评分、BASFI评分无相关性（P>0.05）。结论与尿酸正常者相比，并发高尿酸血症的AS患者呈现出红细胞计数、血清肌酐水平升高及血清总蛋白水平降低的临床特征。血尿酸水平与AS的疾病活动度呈负相关，但高尿酸水平对AS的结构性损伤和功能状态的影响有限。

Objective To explore the clinical characteristics of patients with ankylosing spondylitis (AS) and concomitant hyperuricemia. Methods The clinical data of 169 AS patients were retrospectively analyzed. Patients were divided into hyperuricemia group and normal uric acid group according to the presence of hyperuricemia. The ankylosing spondylitis disease activity (ASDAS⁃CRP or ASDAS⁃ESR) scores, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score, and Bath Ankylosing Spondylitis Functional Index (BASFI) score were adopted to evaluate the disease progression of patients. The sacroiliac grading situation, the Spondyloarthritis Research Consortium of Canada (SPARCC) and SPARCC Sacroiliac Joint Structural Score (SPARCC⁃SSS) were employed to evaluate sacroiliac joints inflammation and structural injury. The clinical data, laboratory indices, disease activity, sacroiliac joints inflammation and structural injury were compared between patients of the two groups. The correlation of blood uric acid level with the disease severity of patients was analyzed. Results Among 169 patients, 38 (22.49%) patients were complicated with hyperuricemia. Age and serum total protein level of patients in the hyperuricemia group were lower than those in the normal uric acid group, and the proportion of males, red blood cell counts and serum creatinine level were higher than those in the normal uric acid group (P<0.05). The BASDAI score of the hyperuricemia group was lower than that of the normal uric acid group (P<0.05), but there was no statistically significant difference in sacroiliitis grading situation, SPARCC sacroiliac joints inflammation score, SPARCC⁃SSS score, ASDAS⁃CRP score, ASDAS⁃ESR score, and BASFI score between the two groups (P>0.05). The results of correlation analysis revealed that the blood uric acid level of AS patients negatively correlated with BASDAI score (P<0.05), but not correlated with ASDAS⁃CRP score, ASDAS⁃ESR score, or BASFI score (P>0.05). Conclusion Compared with patients with normal uric acid, AS patients and concomitant hyperuricemia exhibit clinical characteristics in terms of elevated red blood cell counts and serum creatinine level and decreased serum total protein level. Blood uric acid level negatively correlates with the disease activity of AS, but the effect of high uric acid level on structural injury and functional status of AS is limited.