Influence factors and clinical significance of digestive disturbance in ankylosing spondylitis patients

English Keywords:Ankylosing spondylitis  Digestive disturbance  Influencing factors

English Abstract:

  【Abstract】 Objectives: To investigate the digestive disturbance in ankylosing spondylitis(AS) patients, and to analyze its influence factors and clinical significance. Methods: From July 2014 to April 2015, 101 AS patients were included in this study, consisting of 84 outpatients and 17 inpatients. The parameters of patients, including age, disease duration, history of taking non steroidal anti inflammatory drugs(NSAIDs) and disease modifying anti rheumatic drugs(DMARD), smoking and alcohol history, comorbidities, erythrocyte sedimentation rate(ESR), C reactive protein(CRP) and global kyphosis(GK) were collected. Digestive function was assessed by the Food and Benefits Assessment(FBA) and Functional Digestive Disorders Quality of Life(FDDQL) questionnaires. The patients were divided into mild kyphosis group(GK＜60°, n=67) and severe kyphosis group(GK≥60°, n=34). Correlations of FBA, FDDQL with the influencing factors were calculated by the Spearman coefficients of correlations. Multiple regression analysis was used to investigate the influence factors which impaired digestive function of AS patients. Results: The score of FBA and FDDQL was 63.2±13.5 and 77.4±13.1. The average GK of patients was 52.1°±23.5°. Additionally, the ESR and CRP were 26.6±20.2mm/h and 32.0±22.7mg/L. History of smoking, alcohol, taking NSAIDs and DMARD were found in 52, 40, 48 and 23 patients, respectively. Among them, 3 patients were companied with anemia. There was no significant difference between two groups in questionnaire scores except for the score of coping with disease domain of FDDQL questionnaire. Spearman correlation analysis revealed that FBA was significantly correlated with age, CRP and alcohol(P<0.05), while FDDQL was significantly related to anemia(P<0.05) in mild kyphosis group. Moreover, in severe kyphosis group, no significant correlation was found between FBA and influence factors, and FDDQL was significantly associated with GK and anemia(P<0.05). For all 101 AS patients, significant correlations were observed between FBA and age, NSAIDs as well as alcohol history(P<0.05). Similarly, FDDQL significantly correlated with GK, NSAIDs, DMARD, and anemia(P<0.05). Multiple regression analysis revealed that NSAIDs and alcohol history resulted in lower FBA score, while NSAIDs and anemia leaded to lower FDDQL score. Conclusions: There is no significant difference between AS patients with mild and severe kyphosis in digestive function. The digestive function of AS patients is impaired, which is related to age, GK, NSAIDs, DMARD, alcohol and anemia. Digestive disturbance is not correlated with disease duration, ESR, CRP and smoking. Among them, NSAIDs, alcohol and anemia are the most important factors impairing the digestive function in AS patients.