关注对女性强直性脊柱炎患者的诊治

Focus on Diagnosis and Treatment of Female Patients with Ankylosing Spondylitis

目的:总结女性强直性脊柱炎患者的诊疗经验,以提高临床医师对女性患者的重视。方法:对2012年10月—2013年8月于本院风湿免疫科及骨科门诊就诊的疑似强直性脊柱炎的女性患者712例,通过临床表现、影像学检查及实验室检查对其进行筛查,并予以治疗。结果:根据临床表现及影像学检查有骶髂关节炎改变的591例,诊断为血清阴性脊柱关节病538例,确诊强直性脊柱炎347例。早期诊断率(病程1年以内)仅有15.4%,误诊率83.0%,长期不合理用药率43.0%。经过系统治疗后显效率21.8%,有效率78.2%,无效率0%。结论:女性强直性脊柱炎发病较隐匿,根据临床特点、影像学检查及实验室检查结合临床经验,有助于对女性患者的诊治。

Objective：To sum up the experiences of diagnosis and treatment of female ankylosing spondylitis patients in order to attract the clinical doctors＂ attentism to the female patients. Methods ： The female suspected patients with ankylosing spondylitis who come from department of rheumatism and orthopaedic outpatient service in our hospital in October 2012 to August 2013 were selected by the clinical manifestations, imaging examination and laboratory examination. Results：There were 591 cases of sacroiliac arthritis according to the clinical manifestations and imaging examination, including 347 cases of ankylosing spondylitis in 538 ca- ses of seronegative spondyloarthropathies. The rate of early diagnosis was only 15.4% with course of the disease within 1 year and the rate of mis -diagnosis and the rate of long- term irrational drug- usage were 83.0% and 43.0%. Conclusion：Female anky- losing spondylitis disease is hidden. It＇s conducive to make a diagnosis and give treatment of female patients according to the clin- ical features, imaging examination and laboratory examination combined with clinical experience.