幼年与成年强直性脊柱炎的X线特点对照分析

The comparative analysis of X-ray characteristics of juvenile and adult ankylosing spondylitis

目的比较幼年与成年强直性脊柱炎的x线表现特点。方法收集明确诊断的幼年强直性脊柱炎(JAS)61例,统一按1984年强直性脊柱炎纽约修订标准分级,按发病时间分层随机抽取成人强直性脊柱炎(AS)61例作对照,观察病变侵及骶髂关节、髋关节及脊柱的x线表现,作统计学分析。结果(1)病变分级:骶髂关节幼年组Ⅱ级25个(23.4%),多于成年组9个(7.7%),Ⅳ级13个(12.1%),少于成年组(43.6%),差异有显著性;髋关节幼年组Ⅲ级19个(46.3%),少于成年组34个(43.6%),差异有显著性;椎小关节Ⅲ级3例(16.7%),Ⅳ级7例(38.9%),均少于对照组;(2)X线征象:骶髂关节间隙增宽,幼年组37个(34.6%),多于成年组13个(11.1%),关节间隙变窄35个(32.8%),关节间隙消失13个(12.1%),关节下缘韧带钙化4个(3.7%),均少于成年组71个(60.7%)、54个(46.2%)、42(35.9%),差异有显著性;髋关节间隙变窄15个(36.6%),少于成年组32个(65.3%),差异有显著性;侵犯脊柱18例(29.5%)少于成年组47例(77.0%),差异有显著性,小关节囊钙化1例(5.6%),椎间盘侧缘钙化1例(5.6%),前纵韧带钙化1例(5.6%),少于成年组28(59.6%)、22(46.8%)、20(42.6%),差异有显著性。结论幼年强直性脊柱炎病变侵及骶髂关节、脊柱的X线改变轻于成人,髋关节病变也轻于成人。

Objective To compare the juvenile and adult ankylosing spondylitis characterized by X-ray findings. Methods The diagnosis of juvenile ankylosing spondylitis （JAS） 61 cases, by the onset of a stratified random sample of adult ankylosing spondylitis （AS） 61 examples for the control to observe the lesion invaded sacroiliac joints, hip joints and spine X-ray findings for statistical analysis. Results （1） lesion classification： sacroiliac joint class Ⅱin childhood was 25 （23.4%）, more than nine in adult （7.7%）. Class Ⅳ inl3 （12.1%） children, less than （43.6%） in adult, there was a significant difference between them; class Ⅲin children was 19 （46.3%）, less than 34 in adult （43.6%）, there was a significant difference between them. Vertebral facet grade Ⅲ was three cases （16.7%） and class Ⅳ was seven cases （38.9%） in children, which were less than that in adult; （2） X-ray findings： widening of sacroiliac joint space was detected in 37 （34.6%） children, more than 13 in adult （11.1%）. In young group, joint space narrowing was found in 35 （32.8%） the disappearance of joint space in 13 （12. 1%）, and the lower edge of articular ligament calcification in 4 （3.7%）, which were less than that in adult group, which was 71 （60.7%）, 54 （46.2%）, 42 （35.9%） respectively. There was a significant difference. Hip joint space narrowing in 15 （36.6%） children, significantly less than that in 32 adult （65.3%）.18 cases of children with violations of the spine （29.5%） less than 47 cases of adult （77.0%）, and small joint capsule calcification in 1 case （5.6%）, lateral margin of disc calcification in 1 case （5.6%）, anterior longitudinal ligament calcification in 1 case （5.6%） in young group, which was much less than that of 28 （59.6%）, 22 （46.8%）, 20 （42.6%）in adult group. Conclusion In juvenile ankylosing spondylitis disease, the X-ray findings of sacroiliac joint, spinal and hip are less severe than that in adult.