37例强直性脊柱炎的临床特点及分析

Clinical Features and Analysis of 37 Cases with Ankylosing Spondylitis

目的 :通过对 37例强直性脊柱炎 (AS)的临床分析 ,以提高对此病的诊治水平。方法 :回顾性分析 37例住院病例的临床资料及疗效。结果 :发病年龄高峰在 30岁以前 (占 76 % ) ,隐匿性起病方式为主 (占 81% ) ,首发症状主要是中轴关节受累 (占 70 % ) ,腰痛 ,骶髂关节及腰椎压痛、“4”字试验阳性是常见症状和体征。双侧骶髂关节炎以 3级和 4级为主 ,分别占 6 5 %、2 4%。除 2例手术治疗外 ,35例经消炎止痛药及慢作用药治疗的患者均有明显疗效。结论 :中青年患者 ,特别是 <30岁 ,若出现不能用其他疾病诊断的中轴关节、外周关节病变或少数出现眼部、心血管、肺、肾脏等病变时 ,应考虑到AS ,作双侧骶髂关节CT检查 ,是早期诊断的关键。坚持慢作用抗风湿药治疗 ,对控制症状。

Objective:To improve the diagnosis level and therapeutic effect through the clinical analysis of 37 cases with AS.Methods:The clinical data and therapeutic effect of 37 cases with AS were analyzed retrospectively.Results:back pain,axial arthritis,tenderness over the sacroidiac joint and lumber spine,peripheral arthritis,positive'4'test were the common symptoms and signs.All 37 cases with AS were in patients,therefore,their symptoms and signs were comparatively severe and sacroilitis of Grade 3 and Grade 4 accounted for 65% and 24% respectively.Conclusion:In juvenile patients(especially below 30 years old)with axial arthritis,symptoms of peripheral arthritis、ocular,lung kidney and cardiavascular lesion are helpful for diagnosis,radiological film and CT examination for sacroilitis are the key conditions for early diagnosis and adherence to slow acting rheumatic drug therapy is beneficial in disease controlling.