The Clinic And Experimental Study On Axial Spondyloarthritis

Objective:To investigate the time of delay diagnosis,analyze the possible reasons and related impact in patients with axial spondyloarthritis?SpA?.To evaluate the quality of life and relevant variables associated to its impairment.To explore predictive role in 24 week of the response to TNF-?blocker in first week.To explore comprehensive,objective biomarkers relating to disease features and prognosis.Methods:The differences in the time of first visit delay?t₁?/first visit to diagnosis?t₂?/diagnosis delay(t₁₊₂)were compared according to different initial diagnosis departments and clinic features;the differences in clinic features were compared according to different groups.The quality of life was evaluated by SF12-v2 Health Survey,and demographic and clinical variables were analyzed.To analysis the effect of BASFI change in the first week on ASDAS score in week 24 in active ax-SpA?ASDAS?2.1?patients treated with TNF-?blocker.Factors were examed by protein chip.The relationship between factors and clinic features was analysed.Results:T₂ was shorter in patients selected rheumatology as initial visit department;the ratio of family history was higher in these patients.Men/HLA-B27 positive had longer t₂/t₁₊₂ compared to women/HLA-B27 negative respectively.The t₂ was shorter in patients receiving more than senior high school education.Education/age of onset/uveitis had influence on t₂/t₁₊₂.BASDAI/BASMI were higher in longer t₂ group.BASMI was higher in longer t₁₊₂+2 group.The quality of life in axial SpA patients significantly decreased.The quality of life were strongly correlated with inflammation/disease activity/functional impairment.BASFI had the most influence on PCS.Group had more than 20%BASFI improvements on day1 to day5(d_1-5?^BASFI>20)had lower ASDAS score than d_1-5?^BASFI?20?P<0.05?.D₂?^BASFI>20ASFI>20 group had highest likelihood of achieving inactive disease?ASDAS<1.3?in week24.Only FGFb correlated with BASMI;Only Her2/erbB2correlated with BASDAI;Her2/erbB2/FGFb had influence on ESR?BASFI?ASDAS.Conclusion:The reasons for diagnosis delay involved in initial clinic department/sex/age of onset/HLA-B27/education/uveitis.Delay diagnosis resulted in higher disease activity,functional impairment.The quality of life in patients with axial SpA declined markedly,and the quality of life was strongly correlated with the level of inflammation,the activity of disease,and the function impairment.BASFI had the most influence on PCS.D₂?^BASFI>20 was the stongest predictive of probability of inactive disease in week24.Her2/erbB2/FGFb and highly correlated with inflammation/disease activity/function impairment,will predict prognosis of ax-SpA.