强直性脊柱炎的外周关节病

Peripheral Arthropathy of Ankylosing Spondylitis (AS)

148例强直性脊柱炎AS患外周关节病者130例,发病率为88％,幼年发病组明显高于成年发病组(P<0.01),外周关节炎者47例,其中下肢非对称性关节炎占83％。85％的患者于外周关节病5年内出现腰骶病/或僵硬感。幼年发病组其关节炎、肌腱端病表现及髋关节致残率均高于成年组。有外周关节病组其关节外表现多于无外周关节病组。ESR、CRP和IgA在伴有关节炎的病例中明显升高,故可作为AS活动的参考指标。常规摄骶髂关节X片和行HLA-B27检查有助疾病的早期诊断。

The incidence of peripheral arthropathy in 148 patients with AS was 88 per cent. The pationts with juvenile onset had a higher incidence of peripheral arthripathy as compared with those with adult onset (P<0.01). Asymmetric arthritis of lower limbs accounted for 83 per cent in 47 cases of this condition. Eighty five percent of patients developed lumbosacrol pain and/or stiffiness within five years after the onset of peripheral arthropathy. There was higher rate of arthritis, enthesopathy and disability of hip in patients with peripheral arthropathy than in those without it. The ESR and serum level of CRP and IgA were significantly elevated in patients with arthritis, and this could be regarded as reference indexes of disease activity of AS. Routine radiographic examination of the sacroiliac joints and HLA-B27 detection may facilitate the early diagnosis of AS.