97例强直性脊柱炎临床分析

Clinical analysis of 97 patients with ankylosing spondylitis

目的:探讨AS患者的临床特点,提高AS诊断水平。方法:对97例确诊为AS的住院患者的临床表现、影像学资料、实验室指标等进行分析。结果:58%(56/97)的患者首发症状为中轴关节不适,61%(59/97)的患者病程发展过程中出现周围关节炎;94%(91/97)的患者HLA-B27阳性,RF阴性率达88%(78/89),抗O阴性率为72%(31/43),抗核抗体(ANA)阴性率为90%(77/86),抗环瓜氨酸肽抗体阴性率为98%(40/41),93%(90/97)患者ESR升高,94%(91/97)患者CRP升高;病程1年以上患者骶髂关节CT病变Ⅱ级及以上者比例明显高于病程不到1年者。结论:AS患者早期以中轴关节受累的临床表现多见,HLA-B27对AS的诊断具有重要意义,骶髂关节病变的程度和病程长短有关,应提高对AS的认识,以早期诊断和治疗。

Objective： To investigate the clinical features of ankylosing spondylitis. Methods： Medical records of 97 in-patients diagnosed with ankylosing spondylitis, including the first symptom, laboratory data, CT imaging data and etc, were analyzed. Results： Axial arthritis discomfort was complained as the onset symptom in 58% pa- tients, while 61% patients had peripheral arthritis during the course of disease. Positive HLA-B27, negative RF, elevated ESR and elevated CRP rates were 94% , 88% , 93% and 94% , respectively. Conclusion： The early lesions of AS mostly involves the spine, while severity of sacroiliac lesions was correlated with the course of disease. HLA-B27 gene is important for the diagnosis of AS. We should enhance the understanding of AS, and make early diagnosis and therapy.