太原市血清阴性脊柱关节病的流行病学调查

Epidemiological study of seronegative spondyloarthropathies in Taiyuan

目的了解太原市血清阴性脊柱关节病(SpA)的流行情况。方法参照修订的中国—国际抗风湿联盟风湿病调查表,对太原市某社区16岁以上居民挨户逐人询问,阳性者进行体检,可疑SpA者查人类白细胞抗原(HLA)-B27、类风湿因子(RF);并在1周内拍骨盆正位、腰椎正侧位X线片。X线片由2名放射科医生在不了解病情的情况下读片,最后由3名风湿科医生根据检查结果做出诊断。结果实际调查3915人,符合SpA诊断者35例,患病率为0.89%,其中强直性脊柱炎(AS)8例,占0.20%;未分化脊柱关节病(uSpA)25例,占0.64%,除2例银屑病关节炎(PsA)外,未发现其他SpA。uSpA主要症状为炎症性腰痛(88.0%),RF均(-),12.0%HLA-B27(+),男女比例1.08∶1。结论SpA是常见的风湿性疾病,其主要构成为AS和uSpA。对uSpA的随访有助于AS和其他SpA的早期诊断。

Objective To evaluate the prevalence of seronegative spondyloarthropathies （SPA） in Taiyuan. Methods A population sample of 3915 adults was surveyed. Protocol of the APLAR COPCORD core questionnaire was implemented. Physical examination was done in all who gave positive answers. For those who gave positive response to certain set of questions,rheumatoid factor（RF） ,HLA-B27 and radiographs of pelvis and lumbar spine were done. The X-way films were read blindly and separately by 2 radiologists.Suspected cases of SpA were examined by 3 rheumatologists to ensure international comparability of results. Results The prevalence of SpA was 0.89%,in which the prevalence of AS was 0.2% ,and uSpA was 0.64% ,excepted 2 cases of psoriatic arthritis,no other subset of SpA was found.Sex ratio of male to female was 1.08：1 in uSpA. Of the uSpA cases,the main clinical symptoms were inflammatory low back pain （88.0%）.RF was negative in all patients.12.0% cases were HLA-B27 positive. Conclusion SpA is a common rheumatism, of which, the major subset was AS and uSpA.Clinical follow-up of uSpA is helpful in the early diagnosis of AS and the other SpA.