强直性脊柱炎合并类风湿关节炎患者的临床及实验室特征分析

目的 探讨强直性脊柱炎(AS)合并类风湿关节炎(RA)患者的临床及实验室特征,并与单纯AS及单纯RA患者进行比较,了解AS合并RA(AS-RA)患者的临床及血清学特点.方法 入选AS患者208例,RA患者372例,将其中既符合AS诊断标准又符合RA诊断标准者作为研究对象,并与单纯AS(65例)和单纯RA(83例)比较其特点.结果 在208例AS患者和372例RA患者中有15例既符合AS诊断标准,也符合RA诊断标准,发生频率为AS 7.21%(15/208),RA 4.03%(15/372).与单纯RA及单纯AS比较,AS-RA患者病情炎性活动指标高,骨质破坏重,RF阳性率60.0%(9/15),HLA-B27抗原阳性率为66.7%(10/15),二者同时阳性率为53.3%(8/15),明显不同于RF在单纯RA阳性率(78.2%)和HLA-B27在单纯AS阳性率(92.2%).结论 AS-RA在临床并不少见,具有与单纯AS及单纯RA不同的临床及实验室特征.

The clinical and laboratory features of patients with ankylosing spondylitis and rheumatoid arthritis together

Objective To investigate the clinical and serologic features of patients with ankylosing spondylitis(AS)and rheumatoid arthritis(RA) together,and to compare the information of patients with AS alone or with RA alone,respectively.Methods Two hundred and eight AS patients and three hundred and seventy two RA patients who were admitted to the hospital from 2001 to 2006 were studied retrospectively.The clinical and laboratory features of AS-RA patients were compared with AS alone(n=65)and with RA alone(n=83),respectively.Results fifteen patients were identified with AS and RA together in 208 AS patients (7.21%)and 372 RA patients(4.03%).Compared with the AS patients and with RA patients,patients with AS-RA showed higher disease active parameters and bone erosion.Rheumatic fever(RF) was postive in 9 of 15(60.0%)patients and the HLA-B27 antigen was presenting in 10 of 15(66.7%)patients.The coincidence rate of RF and HLA-B27 was 53.3%(8/15).The postive rate of RF and HLA-B27 in AS-RA patients was different from those in RA alone(78.2%)and AS alone(92.2%),respectively.Conclusion AS-RA patients have distinct clinical and laboratory features that differ from AS or RA patients.