强直性脊柱炎伴发前葡萄膜炎23例临床分析

目的:研究分析强直性脊柱炎(ankylosingspondylitis,AS)伴发前葡萄膜炎患者的临床特征,以提高对本病的诊断水平,降低误诊、漏诊率。方法:选取符合标准的23例前葡萄膜炎患者(共27眼),对其临床表现、实验室检查及诊疗经过进行统计分析。结果:①该23例患者中,男性18例,女性5例,男性患者占比明显高于女性患者;②AS发病年龄为(36±12)岁;葡萄膜炎发病年龄为(30±10)岁;③23例(100%)影像学检查均显示有骶髂关节不同程度的异常改变;15例(65%)HLA-B27检査阳性,12例(52%)血沉升高,5例(22%)C反应蛋自>10mg/L;④治疗上,予糖皮质激素滴眼液局部抗炎、睫状肌麻痹剂扩瞳以防止虹膜后粘连;病情严重者,予全身激素治疗;配合中药汤剂及药物熨敷等中医特色治疗,共治愈患者23例,预后良好。结论:AS伴发前葡萄膜炎发病人群中,青年男性居多,可造成多系统功能受损。根据典型的临床症状、体征及辅助检查可明确诊断。中西医结合治疗可取得良好疗效。

Clinical Analysis of 23 Cases of Ankylosing Spondylitis with Anterior Uveitis

Objective:To study and analyze the clinical features of patients with ankylosing spondylitis(AS)associated with anterior uveitis in order to improve the diagnosis of this disease and reduce the rate of misdiagnosis and missed diagnosis.Methods:Twenty-three patients with anterior uveitis(a total of 27 eyes)who met the criteria were selected for statistical analysis of their clinical manifestations,laboratory examinations,and diagnosis and treatment.Results:①Among the 23 patients,18 were male and 5 were female.The proportion of male patients was significantly higher than that of female patients;②The age of onset of AS was(36±12)years;Years old;③23 cases(100%)showed abnormal changes in sacroiliac joints by imaging examination;15 cases(65%)had positive HLA-B27 test,12 cases(52%)had elevated ESR and(522%)C-reactive protein>10mg/L;④For treatment,give glucocorticoid eye drops for local anti-inflammatory and ciliary muscle paralysis to dilate pupils to prevent posterior iris adhesion;in severe cases,systemic hormone therapy;A total of 23 patients were cured with traditional Chinese medicine treatments such as traditional Chinese medicine decoction and medicine ironing,and the prognosis was good.Conclusion:Among the people with AS associated with anterior uveitis,young men are predominant,which can cause multi-system function impairment.The diagnosis can be confirmed according to typical clinical symptoms,signs and auxiliary examinations.Integrated Chinese and Western medicine treatment can achieve good results.