女性与男性强直性脊柱炎对比研究

Comparative Study on Female and Male Patients with Ankylosing Spondylitis

目的了解不同性别的强直性脊柱炎的临床特点。方法对比性地分析５７例女性ＡＳ（ＦＡＳ）患者和１１４例病程相同的男性ＡＳ（ＭＡＳ）患者（１∶２配对）的临床表现及实验室检查结果。结果平均发病年龄、首发症状、腰椎的Ｘ线受累和病情活动指标在两组无差异（Ｐ＞０．０５）；贫血、外周关节炎和颈椎的受累在女性明显多于男性（Ｐ＜０．０５）；而全身症状、虹膜睫状体炎、严重的骶髂关节及髋关节的Ｘ线受累和ＨＬＡ－Ｂ２７的阳性率在女性明显少于男性（Ｐ＜０．０５）。结论ＦＡＳ患者病情发展较慢，预后较好。这与Ｂ２７阳性率低至少部分地相关。

Objective To investigate the different clinical characteristics of male and female patients with ankylosing spondylitis (AS).Methods The clinical and laboratory features of 57 female AS partients (FAS) were analysed and compared with those of 114 male AS (MAS) patients whose mean duraltion of disease were similar to those of FAS patients (1∶2 match).Results There were no significant differcences between both groups in the mean age of disease onset,first signs,X ray lumbar vertebra lesions and parameters of disease activity.However,More FAS patients developed anemia,peripheral arthritis and cervical vertebra involement ( P <0.05) while the rate of acute anterior uvcitis,constitutional symptoms,severe destructive lesions in hip and sacro iliac joints and HLA-B27 positive rate were less significantly in FAS patients than those in MAS patients ( P <0.05).Conclusion FAS patients have slower disease development and favorable prognosis,which are,at least in part,associated with lower HLA-B27 positive rate. [