ÖZET

Amaç:

Bu çalışmanın amacı, fiziksel performans gerektiren iş koşullarının aksiyel spondiloartrite etkisini klinik, laboratuvar ve radyolojik ölçümler ile araştırmaktır. Ayrıca, ultrasonografik incelemenin iş karakteristiğinin entesopatiye etkisini göstermedeki performansı değerlendirilmiştir.

Gereç ve Yöntem:

Bu çalışma, tek merkezli kesitsel bir analiz olarak yürütüldü. Ekim 2020-Aralık 2020 tarihleri arasında, Uluslararası Spondiloartrit Değerlendirme Derneği kriterlerine göre tanı konulan, 51 aksiyal spondiloartrit (axSpA) hastası (24 kadın, 27 erkek, ortalama yaş: 46,98±9,30 yıl, 15 ankilozan spondilit hastası, 36 nr-axSpA) çalışmaya alındı. Hastaların demografik ve klinik özellikleri, hastalıkla ilgili laboratuvar, radyolojik ve ultrasonografi ölçümleri kaydedildi.

Bulgular:

İşteki çalışma süresi Maastricht ankylosing spondylitis enthesitis score (MASES), ayak deformitesi ve eritrosit sedimantasyon hızı (ESR) pozitif korelasyon içinde iken torakal Schober ile negatif korelasyonludur. İşteki fiziksel aktivite seviyesi ise Bath ankilozan spondilit metroloji indeksi, Bath ankilozan spondilit hastalık aktivite indeksi, ankilozan spondilit hastalık aktivite skoru-ESR, MASES, ayak deformitesi ve ESR ile pozitif olarak korelasyon içinde iken yine torakal Schober ile negatif korelasyonlu bulunmuştur. Boş zamandaki aktivite seviyesi ise yalnızca ayak deformitesi ile pozitif korelasyonludur. Radyolojik parametrelerdeki bulgularda ise işteki çalışma süresinin, distal patellar ve aşil tendon kalınlığı ile pozitif korele olduğu ölçülmüştür. İşteki fiziksel aktivite seviyesi, distal patellar tendon kalınlığı, aşil tendon kalınlığı ve plantar fasya kalınlığı ile pozitif koreledir. Boş zamandaki aktivite seviyesinin ise yalnızca distal patellar tendon kalınlığı ile pozitif korele olduğu görülmüştür.

Sonuç:

AxSpA hastalarının işyerindeki fiziksel aktivite seviyesi, hastalık aktivitesinin şiddeti ve spinal hareketliliğin azalması ile ilgilidir. Özellikle mekanik iş yükünün artması, alt ekstremitede ve tüm entezopati noktalarında, radyolojik progresyon ve hastalık aktivitesinden bağımsız olarak akut enflamasyona neden olur. Ultrasonografik ölçüm, iş yerinde fiziksel aktivite düzeyinin hastalar üzerindeki etkilerinin daha iyi değerlendirilmesini sağlayabilir.

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Çalışma Koşulları ve Aksiyel Spondiloartrit: Klinik, Laboratuvar, Radyoloji ve Ultrasonografi Yöntemleri ile Geniş Bir Perspektiften Değerlendirilmesi

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References