强直性脊柱炎56例临床分析

目的:总结强直性脊柱炎(AS)的临床特点,提高诊治水平.方法:回顾性分析56例强直性脊柱炎患者的临床资料.结果:56例强直性脊柱炎中,男50例,女6例,平均发病年龄28岁;首发症状为慢性腰痛者43例占76.78%;关节外表现仅见虹膜炎10例占17.85%;骨盆正位片全部有骶髂关节炎占100%;HLA-B27阳性52例占92.85%;25例误诊占44.64%;治疗药物主要有非甾体类抗炎药(NSAIDs)、柳氮磺胺吡呤(SSZ)、甲氨蝶呤(MTX)、糖皮质激素等.结论:强直性脊柱炎多见于青年男性,其首发症状多为慢性腰痛,临床易误诊,骨盆正位片、骶髂关节炎及HLA-B27阳性有助于早期诊断和治疗.

Clinical Analysis of Ankylosing Spondylitis (A Report of 56 Cases )

Objective: To analyze the clinical characters of ankylosing(AS) and improve the effect of diagnosis and treatment of AS.Methods: The clinical of 56 patients,with AS diagnosed and treated from 1992 to 2004were analyzed retrospectively.Results: of the 56 patients,50 were male and 6 female,the average age at onset of disease was 28 years old.Chronic back pain,as the initial symptom at onset was observed in 43(76.78);iritis,the only clinical feature other than signs of the joints,was observed in 10(17.85%);pelycographic sacroiliitis,were shown in all 56(100%) patients and HLA-B27 was present in 52(92%).Misdiagnosis was made in 25(44.64%).The major drugs used for AS were NSAIDs SSZ,MTX,glucocorticoid etc.Conclusion: AS occurs more frequently in young men.In most patients with AS the initial symptom is chronic back pain and may be easily misdiagnosed.Sacroiliitis on pelycogram and positive HLA-B27 test are helpful to early diagnosis and treatment of AS.