强直性脊柱炎伴发前葡萄膜炎患者眼前段病变严重程度的相关因素

Relevant factors on the degree of anterior uveitis in patients with ankylosing spondylitis

目的：分析强直性脊柱炎（ AS）伴发前葡萄膜炎患者眼前段病变严重程度和炎性指标以及骶髂关节的影像学表现等相关因素的相互关系。 方法：回顾性分析55例AS伴前葡萄膜炎患者裂隙灯下眼前段病变情况与红细胞沉降率（ ESR ）、C 反应蛋白（ CRP）以及骶髂关节的核磁共振表现。前葡萄膜炎严重程度根据EIU的临床标准改良,骶髂关节骨髓水肿的程度根据SPARCC的骶髂关节（ SIJ）评分,分析二者之间的相互关系。 结果：AS患者55例中,EIU评分为2~10分,SPARCC评分为0~22分。进一步分析表明,葡萄膜炎评分与ESR （r=0.869,P〈0.001）和CRP（r=0.485,P〈0.001）均密切相关。强直性脊柱炎患者前葡萄膜炎严重程度与骶髂关节炎症程度不相关（r=0.237,P=0.081）。 结论：强直性脊柱炎患者前葡萄膜炎局部自身免疫炎症和骶髂关节的炎症及后续的骨化可能是各自独立的两个进程。

AIM： To investigate the association between the degree of anterioruveitis and related factors including inflammatory markers as well as sacroiliac joint imaging in patients with ankylosing spondylitis （AS）. METHODS： Anterior changes evaluated by slit lamp, erythrocyte sedimentation rate （ESR）, C- reactiveprotein （CRP） and magnetic resonance imaging of 55 cases with AS associateduveitis were retrospectively analyzed. A modified endotoxin-induced uveitis （EIU） clinical standard was used for uveitis grading. SPARCC sacroiliac scoring was used to evaluate bone edema of sacroiliac joint. The correlation between the degree of uveitis and sacroiliitis was assessed. RESULTS. In the 55 patients with AS, EIU grading scored 2-10, and SPARCC index scored 0-22. Further analysis showed that the severity of uveitis was significantly correlated with ESR （ r= 0. 869, P〈0.001 ） and CRP （r= 0. 485, P〈0.001 ）. The degree of anterior uveitis in AS patients was not correlated with inflammation of sacroiliac joint （ r= 0.237, P= 0. 081 ）. CONCLUSION： Local autoimmunity of uveitis and sacroiliac joint inflammation with subsequent bone formation in AS might be mutually independent processes.