深圳市3个社区5922名居民强直性脊柱炎的流行病学调查

背景:强直性脊柱炎等风湿性疾病的流行病学调查在深圳市缺如。全面了解强直性脊柱炎在深圳市流行的情况可为有关部门制订卫生规划提供依据。目的:了解深圳市强直性脊柱炎等风湿性疾病的流行情况。设计:随机整群抽取,横断面调查。单位:广东医学院深圳风湿病研究所。对象:于2001-12/2004-06从深圳市3个地区(水乡点、山区点和外来人口聚居点)中各随机整群抽取一个居民点(村民点),经年龄标准化后16岁以上为调查对象,共计6684名,实际调查了5922名,受检率为88.6%,其中男性为2659名,女性为3263名,分别为44.9%与55.1%,男女比例为1∶1.23。方法:第1,2期询问过筛,由调查人员挨家挨户上门调查,对调查对象逐人按调查表内容进行询问、记录。第3期由风湿病专科医师对1、2期询问阳性者进行体格检查。第4期对疑似强直性脊柱炎病例,行人类白细胞抗原-B27抗原检测和X射线摄片,其中包括骨盆平片、腰椎正侧位片;必要时加照脊柱其他部位及周围关节。主要观察指标:风湿病症状频率;强直性脊柱炎患病率;人类白细胞抗原B27抗原阳性频率;并与国内外部分城市相关数据做比较。结果:①一般风湿病症状频率为21.6%,风湿病症状频率以膝关节为最高,依次为腰、肩、颈和手。女性各部位的症状频率显著高于男性(P<0.05)。因风湿病不得不停止工作的,共13例,占4.7%。②强直性脊柱炎患病率为0.37%,男女性患病率之比约为4.5∶1,多数患者是在青年起病。③人类白细胞抗原B27抗原阳性频率为5.0%。④强直性脊柱炎误诊率、早期诊断率和长期不合理用药率分别为64%,27%和73%。结论:深圳市强直性脊柱炎(0.37%)患病率高于国内北京(0.26%)、汕头地区(0.26%)和美国(0.20%)、希腊西方白种人(0.24%),可能与深圳市人口结构青壮年比例较多有关。

Epidemiological survey on prevalence of ankylosing spondylitis in 5 922 Shenzhen inhabitants

BACKGROUND: The data of epidemiological survey on rheumatic diseases such as ankylosing spondylitis (AS) are very rare in China, especially in Shenzhen. The comprehensive understanding of epidemiological situation of AS in Shenzhen can be used to draw up treatment plans by Shenzhen Health Bureau and some other health organizations.OBJECTIVE: To investigate the epidemiological features of AS.DESIGN: Randomized complete collection and cross-sectional investigation.SETTING: Shenzhen Rheumatism Institute of Guangdong Medical College. PARTICIPANTS: From December 2001 to April 2004, totally 6 684 adults aged over 16 years were selected from three regions (one region of river and lakes, one local mountain region and one inhabitant region) of Shenzhen. Among them, 5 922 adults (2 659 males and 3 263 female) were actually investigated and the investigative rate was 88.6%. Males were accounted for 44.9% and females were 55.1%, and the ratio was 1:1.23.METHODS: Step 1 and 2, the investigated individuals were questioned and their answers were recorded by the investigators. The questionnaire proceeded one by one for every individual and proceeded at homes. Step 3,the individuals with positive findings at steps 1 and 2 were examined by rheumatologic doctors. Step 4, individuals with suspected AS were subjected to human leukocyte antigen B27 (HLA-B27) assays, radiographies including plain pelvic films, plain lumbar-vertebral films and if necessary, radiographies at other areas of spinal column as well as peripheral joints.MAIN OUTCOME MEASURES: Frequencies of rheumatic complaints,prevalence rate of AS, positive frequencies of hum an HLA-B27, and comparisons with relevant data abroad.RESULTS: ① General frequency of rheumatism was 21.6%, and the highest complaint was at knee joint, then at waist, shoulder, neck and hand. In female, the frequencies of complaints at every joint mentioned above were higher than those in male (P ＜ 0.05). A total of 13 patients (4.7%) had to discontinue their work because of rheumatic diseases. ②Prevalence rate of AS was accounted for 0.37%, and the ratio between male and female was 4.5: 1. The onset of AS began at middle age in majority patients. ③ Positive frequency of HLA-B27 was 5.0%. ④ Rate of misdiagnosis, the rate of early diagnosis and the rate of long-term irrational drug-usage were 64%, 27% and 73%, respectively.CONCLUSION: In Shenzhen, the prevalence rate of AS (0.37%) is ranked higher than that in Beijing (0.26%), Shantou (0.26%), America(0.20%) and the whites of Greece (0.24%). The differences among them may be connected with the fact that in Shenzhen the young people occupy a large proportion of population.