幼年强直性脊柱炎骶髂关节炎CT表现及其与性别、病程、年龄的相关性研究

CT features of sacroiliitis and its relationship with gender, disease duration and onset age of juvenile ankylosing spondylitis

目的:研究幼年强直性脊柱炎(JAS)骶髂关节病变的CT表现及其与性别、病程、年龄的关系。材料与方法:2001年9月-2003年3月于我院确诊的JAS患者共120例,男106例,女14例。发病年龄4-16岁,平均(12.06±3.0)岁。就诊年龄9-30岁,平均(17.03±2.3)岁。病程3个月-23年,平均(4.10±3.79)年。所有被检查者均行骶髂关节的CT扫描。将骶髂关节炎按1984年美国纽约修订标准分级并作与性别、病程、年龄的相关性研究。结果:JAS患者90.83%于8岁以后发病,男、女发病年龄相似,女性平均病程[(7.02±5.4.1)年]比男性[(3.71±3.36)年]长。骶髂关节单侧发病24例占20%,双侧对称发病66例占55%,双侧不对称发病30例占25%。骶髂关节单、双侧发病与发病年龄无关,而与病程有关。病程在1年之内,骶髂关节双侧发病与单侧发病之比为1.7:1;病程在1-5年,两者比率为5.4:1;病程超过5年,则增高至7.8:1。骶髂关节炎0级24个关节,Ⅰ级27个关节,Ⅱ级51个关节,Ⅲ级117个关节,Ⅳ级21个关节。骶髂关节病变的严重程度与病程呈正相关,而与性别、发病年龄无关。总体上左侧与右侧骶髂关节炎的严重程度相似。结论:JAS患者男女发病年龄相似,但女性病程长。随病程的延长,骶髂关节双侧发病的比率明显增高。骶髂关节炎的严重程度与病程呈正相关,随病程的延长,病变加重,而与性别及发病年龄无关。

Objective： To study CT features of sacroiliitis and its relationship with gender, disease duration and age of juvenile ankylosing spondylitis （JAS）. Materials and Methods： One hundred and twenty patients with JAS collected from September 2001 to March 2003 were studied. There were 106 males and 14 females. The present age of patients ranged from 9 to 30 years old with a mean of 17.03±2.3 years old. The onset age ranged from 4 to 16 years old with a mean of 12.06±3.0 years old. The disease duration ranged from 3 months to 23 years with a mean of 4.10±3.19 years. CT scans of sacroiliac joint of all patients were obtained. Sacroiliitis were graded according to the New York criteria revised in 1984 and its relationship with gender, disease duration and age were studied. Results： The onset age of JAS was more than 8 years old in 90.8% of cases. Although there was no significant difference in the mean onset age in male and female, the mean disease duration in female was longer. Twenty-four cases（20%） were unilateral sacroiliitis, 66 cases（50%） were bilateral sacroiliitis. In thirty cases（25%） of bilateral sacroiliitis was asymmetry on two sides. Bilateral or unilateral sacroiliitis was related to the disease duration but not onset of age. If the disease duration was within 1 year, the ratio of bilateral sacroiliitis to unilateral sacroiliitis was 1.7：1. If the disease duration was within 1-5 years, the ratio was 5.4：1. If the disease duration was over 5 years, the ratio was 7.8：1. There were 24 joints which was of grade 0 sacroiliitis, 27 joints of grade Ⅰ, 51 joints of grade Ⅱ, 117 joints of grade Ⅲ, 21 joints of grade Ⅳ. The degree of sacroiliitis on the left side was in accordance with the right side. The severity of sacroiliitis was related to disease duration, but not onset age and gender. Conclusion： The onset age in male and female patients with JAS is similar, but the disease duration is longer in female than in male. JAS can involve unilateral or bilateral sacroiliac joint. With the disease duration longer, the ratio of bilateral sacroiliitis to unilateral sacroiliitis is obviously elevated. The sacroiliitis aggravates with the duration of disease, but not onset age and gender.