汕头地区15年强直性脊柱炎的临床分析

目的 了解本地区强直性脊柱炎（ＡＳ）的临床特点,提高诊治水平。方法 回顾性分析１９８３～１９９７年３７０例专门诊诊治的ＡＳ病人的一般临床资料、治疗及随访结果。结果 ９４％的病例隐匿发病。腰痛、外周关节炎、“４”字试验阳性、骶骼关节压痛和腰椎压痛为常见症状和体征。骶骼关节受累程度、髋关节和脊柱受累均与病程有关;儿童ＡＳ髋关节受累与病程关系不大;也有病程１６年但骶骼关节炎仍为Ⅱ级者。治疗头２年症状、体

Ankylosing spondylitis in Shantou: clinical experience in fifteen years

OBJECTIVE: To evaluate the clinical features of ankylosing spondylitis (AS) in Shantou area and improve the diagnostic level and therapeutic effect. METHODS: Clinical and laboratory data, and the methods and effects of therapy were analyzed. Some patients were followed up. RESULTS: 94% of the cases had an insidious onset. Low back pain or discomfort, peripheral arthritis, positive "4" test and pressing tenderness over the sacroiliac joints and lumbar spine were the frequent symptoms and signs. The degree of sacroiliitis and involvement of hip and spine were related to the disease duration. However, hip joint involvement in juvenile onset AS did not relate to the disease duration. Some cases with disease duration as long as 16 years still remained at II of degree sacroiliitis. Clinical improvement was more obvious in the first two years of treatment. Although some patients came to a standstill condition after this period, yet the disease activity might still relapse with withdrawal of the treatment. The rate of adhering to the treatment for 1, 2, and over 5 years was 34.6%, 28.4%, and 10.3% respectively. The radiological changes frequently did not parallel with the clinical manifestations. CONCLUSION: Early diagnosis is of importance in improving the prognosis of AS and adherence to slow-acting anti-rheumatic drug therapy is beneficial in disease controlling. A follow up of more than 3 years is necessary to estimate the therapeutic efficacy, and the radiological change is the key indicator. AS is a heterogenic disease and the risk factors for prognosis should be further studied.