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目的研究强直性脊柱炎(ankylosing spondylitis,AS)患者的饮食习惯与健康人群的差异,探讨饮食这一环境因素在AS发病中的作用。方法对2014年7月到2015年4月在我科就诊的123例AS患者及年龄、性别匹配的120例健康志愿者进行饮食习惯的现况调查,采用单因素及多因素分析比较AS患者和健康对照人群饮食习惯的差异。根据Bath强直性脊柱炎病情活动指数(BASDAI)将AS患者分为病情活动组(BASDAI>4分)和病情无活动组(BASDAI≤4分),研究病情活动与饮食习惯的关系;根据HLA-B27的表达将患者分为HLA-B27阳性组和HLA-B27阴性组,研究饮食和HLA-B27的交互作用对AS发病的影响。结果 AS患者和健康对照人群之间在饮食口味倾向、主食结构、平均每天高胆固醇食物、每天豆类制品、是否吸烟、饮酒频率等饮食习惯上差异存在统计学意义(P<0.05)。多因素分析发现嗜辣口味、每天适量豆制品摄入、适量饮酒是AS发病的保护因素,每天吸烟是AS发病的独立危险因素(P<0.05)。AS病情活动与饮食习惯无关。HLA-B27阳性的患者在饮食口味倾向、豆制品的摄入、吸烟、饮酒等方面与健康对照人群差异有统计学意义(P<0.05,P<0.01)。结论饮食结构不同可能是AS发病的重要环境因素之一,HLA-B27与饮食习惯对AS发病的影响可能存在交互作用。
Objective To investigate the differences between dietary habits and healthy subjects in patients with ankylosing spondylitis (AS) and to explore the role of dietary environmental factors in the pathogenesis of AS. Methods A total of 123 AS patients treated in our department from July 2014 to April 2015 were enrolled and 120 healthy volunteers matched for age and sex were surveyed for dietary habits. Single-factor and multivariate analysis were performed to compare the prevalence of AS patients and Differences in eating habits among healthy controls. According to the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), AS patients were divided into two groups according to their activity status (BASDAI> 4 points) and patients with no activity status (BASDAI≤4 points) The expression of B27 divided the patients into HLA-B27-positive group and HLA-B27-negative group and studied the influence of the interaction between diet and HLA-B27 on the pathogenesis of AS. Results There was a significant difference (P <0.05) between AS patients and healthy control subjects in terms of dietary preference, staple food structure, daily high cholesterol foods, daily soy products, smoking and drinking frequency. Multivariate analysis found that spicy taste, daily intake of soy products, moderate drinking is a protective factor in the pathogenesis of AS, daily smoking is an independent risk factor for AS (P <0.05). AS disease activity and diet has nothing to do. The HLA-B27-positive patients had statistically significant differences (P <0.05, P <0.01) in the aspects of dietary preference, soy product intake, smoking, drinking and other aspects. Conclusion Different dietary patterns may be one of the important environmental factors for the pathogenesis of AS. The interaction between HLA-B27 and eating habits may have an impact on the pathogenesis of AS.