强直性脊柱炎及其评分ppt课件

强直性脊柱炎及其评分强直性脊柱炎及其评分强直性脊柱炎及其评分0utlineBASDAIBASFIBASMIBAS-GMASESASDAS改良Stoke强直性脊柱炎脊柱评分(mSASSS)强直性脊柱炎生活质量问卷(ASQoL)强直性脊柱炎评价(ASAS)0utlineBASDAI毕氏疾病活动度评分（毕氏疾病活动度评分（BASDAI）nfatiguenpain of the spine and hipsnpain or swelling of the peripheral jointsn localised tenderness as a proxy for enthesitisn severity and duration of morning stiffness.nThe index consists of six“10-cm”horizontal VAS to measure severity of fatigue,spinal and peripheral joint pain,localized tenderness,and morning stiffness(both qualitative and quantitative).毕氏疾病活动度评分（BASDAI）fatigueBASDAI（过去的一周内）n1.您身体疲倦的总体程度：n2.您的颈部、背部或髋关节的整体疼痛程度:n3.除颈部、背部或髋关节外，您的其他关节疼痛或肿胀的整体程度：n4.您身体的触痛或压痛部位的整体不适程度 n5.您起床时腰背部的整体僵硬程度：n6.从起床开始计算，您腰背部僵硬持续的时间：0 h 0.5h 1h 1.5h 2h 0分 2.5分 5分 7.5分 10分 n 计算公式计算公式 0.2X 0.2X（A+b+c+d+(E+F)/2A+b+c+d+(E+F)/2）评定标准：评定标准：44分活动分活动BASDAI（过去的一周内）1.您身体疲倦的总体程度：强直性脊柱炎病情活动判断强直性脊柱炎病情活动判断-BASDAI-BASDAI-BASDAI-BASDAI评价评价评价评价n nA A 过去过去过去过去1 1周你感受到的周你感受到的周你感受到的周你感受到的疲劳疲劳疲劳疲劳/困倦困倦困倦困倦的总体程度的总体程度的总体程度的总体程度n nB B 过去过去过去过去1 1周你感受到的周你感受到的周你感受到的周你感受到的颈痛、背痛和髋痛颈痛、背痛和髋痛颈痛、背痛和髋痛颈痛、背痛和髋痛的总体程度的总体程度的总体程度的总体程度n nC C 过去过去过去过去1 1周你感受到的周你感受到的周你感受到的周你感受到的其他关节疼痛其他关节疼痛其他关节疼痛其他关节疼痛/肿胀肿胀肿胀肿胀(不包括颈痛、不包括颈痛、不包括颈痛、不包括颈痛、背痛和髋痛背痛和髋痛背痛和髋痛背痛和髋痛)的总体程度的总体程度的总体程度的总体程度n nD D 过去过去过去过去1 1周你感受到的因周你感受到的因周你感受到的因周你感受到的因触痛导致不适触痛导致不适触痛导致不适触痛导致不适的总体程度？的总体程度？的总体程度？的总体程度？n nE E 过去过去过去过去1 1周你清醒后感受到的周你清醒后感受到的周你清醒后感受到的周你清醒后感受到的晨僵晨僵晨僵晨僵的总体程度？的总体程度？的总体程度？的总体程度？n nF F 当你清醒后当你清醒后当你清醒后当你清醒后晨僵晨僵晨僵晨僵持续多长时间？请在下列标尺上标出持续多长时间？请在下列标尺上标出持续多长时间？请在下列标尺上标出持续多长时间？请在下列标尺上标出0 00.5h0.5h1.0h1.0h1.5h1.5h2h2h 无无无无0;0.5h0;0.5h25;1.0h25;1.0h50;1.5h50;1.5h75;2h75;2h1001005 5项项项项强直性脊柱炎病情活动判断-BASDAI评价A 过去1周你感Bath Ankylosing Spondylitis Functional Index(BASFI)nThis measure includes ten items which ask the respondents about their perception of their functional ability and how well they are able to function in everyday life.nSubjects rate their functional ability from 010 on a VAS that best describes the current condition.nThe mean of the ten scales gives the BASFI score(range,010cm).The SDD for the BASFI is 2.1 cm.Bath Ankylosing Spondylitis FuBASFIn1无需借助帮忙而能穿上袜子或紧身衣n2能自己弯腰从地上拾起钢笔n3无需借助帮助而能触及比自己高的地方n4不用手支撑或借助帮助而能从无扶手的椅子上站起来n5躺在地板上，无需他人帮助而能站起来n6独立站立10分钟无不适感n7不扶栏杆也不依靠工具而能爬1215级楼梯(每步一梯级)n8不转动躯干即能望向您的肩部n9能进行体能活动，如物理训练、散步或其他体育运动n10做家务活或上班，均能完成一整天的活动 取得分的均值BASFI1无需借助帮忙而能穿上袜子或紧身衣Bath强直性脊柱炎度量指数BASMIBath强直性脊柱炎度量指数BASMIBASMIA new scoring system for the Bath Ankylosing Spondylitis:Metrology Index.BASMIA new scoring system for Bath Ankylosing Spondylitis Global Score(BAS-G)nThe purpose of this measure is to make a global assessment of the well-being of the person with AS over a given period of time.nThe questions ask the patients to rate the effect of AS on their well-being over the last week and the last 6 months.n The score range is 0=none to 10=very severe effect.The mean of the two scales gives the BASG(score range:010).Bath Ankylosing Spondylitis Gl“Maastricht Ankylosing Spondylitis Enthesitis Score”(MASES)nAssessment for enthesitisnWithout gradationnRange（0-13）Disease measurement enthesitis,skin,nails,spine and dactylitis.Best Practice&Research Clinical Rheumatology(2010)Spondylitis Assessment of enthesitis in ankylosing.Ann Rheum Dis.(2003)“Maastricht Ankylosing SpondylMaastricht强直性脊柱炎附着点炎评分Maastricht强直性脊柱炎附着点炎评分强直性脊柱炎疾病活动性评分强直性脊柱炎疾病活动性评分(ASDAS)n该公式包含该公式包含5项变量：总体背痛评分、患者总体评分、项变量：总体背痛评分、患者总体评分、晨僵时间、晨僵时间、C反应蛋白和血沉。反应蛋白和血沉。n注：腰背痛、患者总体评价、晨僵持续时间、外周注：腰背痛、患者总体评价、晨僵持续时间、外周关节疼痛关节疼痛/肿胀及疲倦均采用肿胀及疲倦均采用10cm的的VAS来衡量，来衡量，评分为评分为0-10分分(10分为非常严重分为非常严重)。腰背痛、晨僵持。腰背痛、晨僵持续时间和疲倦分别为续时间和疲倦分别为BASDAI第第2个、第个、第6个和第个和第1个个问题。问题。强直性脊柱炎疾病活动性评分(ASDAS)该公式包含5项变量：ASDASnASDAS1=0.122腰背痛腰背痛+0.061晨僵持续时间晨僵持续时间+0.119患者患者总体评价总体评价+0.210血沉的平方根血沉的平方根+0.383(C反应蛋白反应蛋白+1)的自的自然对数然对数 n ASDAS2=0.079腰背痛腰背痛+0.069晨僵持续时间晨僵持续时间+0.113患者总体评价患者总体评价+0.086外周关节疼痛外周关节疼痛/肿胀肿胀+0.293血沉的平方血沉的平方根根 n ASDAS3=0.121腰背痛腰背痛+0.058晨僵持续时间晨僵持续时间+0.110患者总体评价患者总体评价+0.073外周关节疼痛外周关节疼痛/肿胀肿胀+0.579(C反应蛋白反应蛋白+1)的自然对数的自然对数 n ASDAS4=0.152腰背痛腰背痛+0.069晨僵持续时间晨僵持续时间+0.078疲倦疲倦+0.224血沉的平方根血沉的平方根+0.400(C反应蛋白反应蛋白+1)的自然对的自然对数数 ASDASASDAS1=0.122腰背痛+0.061晨僵ASDASCut-offs proved to have external validityVery good performance vs.existing criteria Identification of proposed cut-offs using NOR-DMARD registry,cross-validation performed in ASSERTASDASCut-offs proved to have e改良Stoke强直性脊柱炎脊柱评分(mSASSS)nThe mSASSS system contained a score for the lumbar spine and a score for the cervical spine.n The total score is the sum of both scores(range 072).Assessment of outcome in ankylosing spondylitis:an extended radiographic scoring system.Ann Rheum Dis 2005改良Stoke强直性脊柱炎脊柱评分(mSASSS)The mmSASSSnLumbar spine:the lower border of the 12th thoracic vertebra,all five lumbar vertebrae,the upper border of the sacrum,viewed on the lateral radiograph.The corresponding nominal scoring system was used:0=no abnormality;1=erosion,sclerosis or squaring;2=syndesmophyte;and 3=total bony bridging at each site.Assessment of outcome in ankylosing spondylitis:an extended radiographic scoring system.Ann Rheum Dis 2005mSASSSLumbar spine:Assessment mSASSSnCervical spine:nThe scoring system was identical to that of the lumbar spine.The lower border of the 2nd cervical vertebra up to and including the upper border of the 1st thoracic vertebra were viewed on the lateral radiograph.nOwing to the original straight shape of the lateral surface of the 3rd cervical vertebra it was decided that this vertebra should not be scored for squaring,although erosions and sclerosis were scored.Assessment of outcome in ankylosing spondylitis:an extended radiographic scoring system.Ann Rheum Dis 2005mSASSSCervical spine:AssessmeRadiographic Ankylosing Spondylitis Spinal Score(RASSS)2009,American College of RheumatologyRadiographic Ankylosing SpondyRASSSnThe inclusion of the lower part of the T-spine significantly increases the sensitivity to change when scoring radiographic damage in AS because more syndesmophytes are potentially scored.n The new tool,the RASSS,has better face and content validity than the mSASSS.nOverall,it proved to be clearly superior for the assessment of structural damage in patients with AS.The RASSS should be further evaluated in clinical trials and cohort studies of patients with AS.Development of a Radiographic Scoring Tool for Ankylosing Spondylitis Only Based on Bone Formation:Addition of the Thoracic Spine Improves Sensitivity to ChangeRASSSThe inclusion of the lowe强直性脊柱炎生活质量问卷(ASQoL)Development of the ASQoL:a quality of life instrument specific to ankylosing spondylitis强直性脊柱炎生活质量问卷(ASQoL)DevelopmenASQoLASQoL强直性脊柱炎生活质量问卷(ASQoL)n目前的身体状况限制了我的活动范围n有时候疾病的痛苦使我想哭n我穿衣服有困难n做家务活有困难n疼痛使我难以入睡n我不能参与家庭或朋友们的集体活动n我一整天都感觉疲倦n我必须停止手头的工作去休息n疼痛使我无法忍受n晨起的僵硬感使我很久才能起身活动n我几乎不能做家务劳动n我很容易疲倦n我经常觉得失落n我感到疼痛一直持续存在n我因为此疾病而失去了很多机会n我洗头发有困难n我的状况使我感到灰心失望n我担心我让周围人失望强直性脊柱炎生活质量问卷(ASQoL)目前的身体状况限制了ASQoLnThis measure adopted the needs-based model that postulates that QoL is dependent on an individuals ability to meet his or her needs.n It is a fixed-response questionnaire that asks endorsement(yes/no)of 18 items related to symptoms,functioning,and disease-related concern.nThe ASQoL questionnaire has been validated in UK and The Netherlands.ASQoLThis measure adopted the ASAS20Ankylosing Spondylitis Assessment Group Preliminary Definition of Short-Term Improvement in Ankylosing Spondylitis.ARTHRITIS&RHEUMATISM.2001ASAS20Ankylosing Spondylitis A强直性脊柱炎及其评分ppt课件Have a happy and blessed New Year!Have a happy and blessed New Y