| Objective To explore the correlation between clinical infection and disease activity index variation by investigating the infection and monitoring disease activity index in the patients with ankylosing spondylities.Methods 110 patients who were treated the hospital between October 2014 and January 2016 with ankylosing spondylities were enrolled in this study. The basic information, the symptoms of infection in past 12 weeks and their ESR, CRP, BASDAI and ASDAS scores were recorded. The relationship between current(former 1 week), recent(former 1-4 week), long-term(former 4-12 week) infection and disease activity indices were analyzed. The patients with current infection or having no infection nearly 12 weeks were followed to explore the variation of the disease activity index after infection(1st month, 3rd month and 6th month).Results 1 Among 110 patients with ankylosing spondylitis, the mean age was 29.08 ± 8.45 years old, duration was 5.66 ± 5.23 years, there were 99 males and 11 females, the proportion between male and female was nearly 9: 1. In the past 12 weeks, 80(73%) had clinical symptoms of infection, 30(27%) had not. Between the infection group and the non-infection group, the age, ESR and CRP had no significant differences, but the duration(4.88 ± 4.70; 7.79 ± 6.05), BASDAI(4.19 ± 1.81; 3.16 ± 1.37) and ASDAS(3.18 ± 0.96; 2.68 ± 0.96) had significant differences(P=0.010, P=0.002 and P=0.017, respectively). In the past 1 week, 38(35%) had current infection, 72(65%) had not. The ESR(41.74±24.97;25.46±24.83), CRP(37.52±47.43;16.44±19.35), BASDAI(4.36±1.96;3.67±1.60)and ASDAS(3.39±1.08;2.87±0.88) had significant differences(P=0.001, P=0.012, P=0.050 and P=0.007, respectively) between the two groups. 2 Among the 80 patients with clinical infections in the last 12 weeks, 51%(n=56) had respiratory tract infection, 33%(n=35) were gastrointestinal infection, 12%(n=13) were urogenital tract infection, 2%(n=2) was skin infection. In the respiratory tract infection group, there were 4 with fever, 1 with chills, 5 with headache, 23 with nasal congestion, 30 with runny nose, 19 with sore throat, 13 with mouth ulcers, 28 with cough, 15 with sputum. In the gastrointestinal infection group, there were 3 patients with abdominal pain, 11 with diarrhea, 3 with dry stool, 19 with loose stools, 7 with constipation. In the urogenital tract infection group, there were 3 of painful urination, 6 of frequent urination, 3 of urgency, 1 with urinary discomfort, 5 with prostatitis. In the skin infection group: there were 2 with rash. The disease activity index among the respiratory tract, gastrointestinal and urogenital tract infection group had no significant difference, but the age of urogenital tract infection group were older than the respiratory tract and gastrointestinal infection group(P<0.001, P=0.003, respectively). 3 80 patients of infection nearly 12 weeks were divided into three groups, 38 in current infection, 37 in recent infection and 35 in long-term infection, and 26 had persistent or recurrent infection. Compared the current infection group with the recent infection group and the long-term infection group, the ESR and CRP had significant differences(P=0.002, P=0.005 and P=0.024, P=0.018, respectively), but the BASDAI(P=0.477, P=0.625, respectively) and ASDAS(P=0.103, P=0.061, respectively) had no significant differences. In patients with respiratory tract infection, the current infection group compared to the recent infection group, their ESR was significantly higher(P=0.028), the CRP had no significant difference(P=0.055), but compared the current infection group with the long-term infection group, the ESR had no significant difference(P=0.126), the CRP was significantly higher(P=0.049), the BASDAI and ASDAS had no significant difference among these three groups. For the gastrointestinal infection patients, Compared the current infection group with the recent infection group and the long-term infection group, the ESR(P<0.001 and P<0.001, respectively),CRP(P=0.022 and P=0.016, respectively) and ASDAS(P=0.005 and P=0.011, respectively) had significantly differences, but the BASDAI(P=0.402 and P=0.629, respectively) had no significant difference. For the urogenital tract infection patients, with infection in different periods, the ESR, CRP, BASDAI, ASDAS had no significant difference. 4 The patients with infection in the former week of the first time of treated in hospital and the non-infector in last 12 weeks were followed-up for 6 months. Between the infected and non-infected group, the ESR, CRP, BASDAI had significant differences(P<0.001, P=0.003, P=0.005, respectively), but the ASDAS had no significant difference(P = 0.060). The ESR, CRP, BASDAI and ASDAS scores were improved at the first, third and sixth month after infection. Compared with the baseline, the difference was statistically significant(P <0.050). At the first month, the disease activity index improved significantly. But it has no significant improvement in non-infectors(P> 0.050).Conclusion 1 Infection was prevalent in past 12 weeks among patients with ankylosing spondylitis, the occurrence rate was about 73%, respiratory tract infection acount for 51% of all infectons, followed by gastrointestinal infections 33%, urinary tract infection was 12% and the skin infections least 2%. 2 Among the 110 patients of Ankylosing spondylitis, the BASDAI and ASDAS of the infectors nearly 12 weeks were increased, and the ESR, CRP, BASDAI and ASDAS of current infectors were increased. 3 The effects to the patients with Ankylosing spondylitis were affected by the site and time of the infection. In the respiratory tract infection group, between the current infection group, the recent infection group and the long-term infection group, only the ESR and CRP increased, while the BASDAI and ASDAS had no significant difference. In the gastrointestinal infections group, the ESR, CRP and ASDAS increased significantly, while the BASDAI had no significant difference. In the urogenital tract infection group, the ESR, CRP, BASDAI, ASDAS had no significant difference.4 For the patients of ankylosing spondylitis, the disease activity index improved in varying degrees after the time of infection, but there was no significantly improvement in non-infectors. |
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