强直性脊柱炎伴葡萄膜炎的临床特征及治疗

Clinical characteristics and treatment of uveitis associated with ankylosing spondylitis

目的:探讨强直性脊柱炎(ankylosing spondylitis,AS)伴发葡萄膜炎的临床表现和诊治。方法:收集我院自2012-08/2015-08就诊并最终确诊为AS伴葡萄膜炎的患者40例46眼,对其临床特征、实验室检查和诊治情况进行系统回顾性分析。结果:AS伴发葡萄膜炎患者40例46眼,其中男28例32眼,女12例14眼。平均发病年龄29.68±7.83岁,平均病程6.95±6.12a;葡萄膜炎病史3d^6a,平均病程28±15d。X线或CT检查显示均有骶髂关节炎。患者37例(93%)人白细胞抗原B27(human leukocyte antigen,HLAB27)检查阳性,27例(68%)血沉(erythrocyte sedimentation rate,ESR)升高,18例(45%)C反应蛋白(C-reactive protein,CRP)升高。经过系统治疗后,患者的葡萄膜炎得到治愈或控制,实验室检查指标恢复正常。结论:AS伴发葡萄膜炎多累及中青年男性,多单眼发病,易复发;临床医生需警惕葡萄膜炎患者AS的发生。该类患者需及时、足疗程地系统治疗。

AIM： To investigate the clinical characteristics and treatment of uveitis associated with ankylosing spondylitis （AS）. ~ METHODS： Totally 40 uveitis associated with AS patients （46 eyes） were collected from August 2012 to August 2015 in our department. Data of these patients concerning clinical characteristics, laboratory examinations and treatment were retrospectively analyzed. RESULTS： Of the 40 patients, 28 were males（32 eyes） while the remaining 12 were females （14 eyes）. The mean age of the patients at onset of AS was 29.68±7.83 years old, while the average duration was 6.95±6.12a. The history of uveitis of these AS patients was 3d to 6a, with a mean duration of 28± 15d. All patients showed typical sacroiliitis with X- ray or CT examination; 37 patients （93%） were HLA - B27 positive; Erythrocyte sedimentation rate （ESR） of 27 patients （68%） increased while 18 patients （45%） showed increased C-reactive protein （CRP）. Uveitis of all patients was either cured or under good control after treatment with corticosteroids and cycloplegic eye drops. CONCLUSION： Young males suffer more than female with uveitis associated with AS, which is often characterized by unilateral onset and recurrent relapse. Clinical doctors should pay more concerns on the uveitis patients the onset of AS. Early and enough treatment were needed for these patients.