强直性脊柱炎非骨水泥型全髋关节置换术后中期随访

目的:观察强直性脊柱炎非骨水泥型全髋关节置换术后中期的随访结果。方法:对37例(52髋)强直性脊柱炎非骨水泥型全髋关节置换术后患者进行了24～172个月,平均69个月的随访。临床随访根据Harris的评分方法进行评分,X线随访根据Gruen等和DeLee and Charnley分区法分别进行股骨柄和臼杯X线分析,根据Brooker等0～4级分级法进行异位骨化分级。结果:患者髋关节屈伸、收展、内外旋总活动度由术前的平均27°提高到术后平均152°。术后无脱位、感染等并发症发生。Harris评分术前平均为32(8～64)分,术后平均为82(64～96)分,其中优38髋,良8髋,可6髋,优良率88.5％。X线片分析未见假体松动,11髋(21.2％)发生异位骨化。结论:人工全髋关节置换术治疗强直性脊柱炎髋关节病变,中期可取得满意的临床效果。     

Low frequency of HLA-B27 and scarcity of ankylosing spondylitis in a Zairean Bantu population

Ankylosing spondylitis (AS) is an inflammatory rheumatic disease which is thought to be rarely seen in African Blacks. Its genetic predisposition has been stressed in Caucasians where the HLA-B27 antigen is firmly linked to the disease. In the present study, HLA-B27 antigen was determined in 146 individuals of Bantu root. Only one of these subjects was found to possess HLA-B27 antigen. This study correlates the low frequency of HLA-B27 with the observed scarcity of AS in patients attending a clinic in Kinshasa for osteoarticular diseases.     

Population studies of leukocyte-reactive antinuclear antibody and HLA antigens

Summary The prevalence of serum leukocyte-reactive antinuclear antibody (LR-ANA) was determined in 31 patients with ankylosing spondylitis (AS), their age-and gender-matched normal controls, and two tribes of 340 West Coast Canadian Indians (Bella Coolas and Haidas). At a serum dilution of 1:10, the prevalence of LR-ANA in AS and controls was 45% and 7%, respectively. At 1:20 dilution, the prevalence was 23% in AS, 0% in controls, 29% in Bella Coolas and 27% in Haidas. No concordance was found among LR-ANA, HLA-B27 and CREG-B7, and nine HLA-A and seven HLA-B antigens in the Indian tribes. These studies confirm an increased prevalence of LR-ANA in AS and AS kindreds. but the latter association appears to be independent of HLA antigens.     

The association between HLA antigens and the presence of certain diseases

The association between the presence or absence of two HLA antigens and coeliac disease, thyrotoxicosis and ankylosing spondylitis has been studied in patients and controls. The simple empirical logistic model and a refinement due to Dyke and Patterson have been used to examine which conditional associations are important.     

High signal intensity of intervertebral calcified disks on T1-weighted MR images resulting from fat content

Objective To explain a cause of high signal intensity on T1-weighted MR images in calcified intervertebral disks associated with spinal fusion.Design and patients Magnetic resonance and radiological examinations of 13 patients were reviewed, presenting one or several intervertebral disks showing a high signal intensity on T1-weighted MR images, associated both with the presence of calcifications in the disks and with peripheral fusion of the corresponding spinal segments. Fusion was due to ligament ossifications (n=8), ankylosing spondylitis (n=4), or posterior arthrodesis (n=1). Imaging files included X-rays and T1-weighted MR images in all cases, T2-weighted MR images in 12 cases, MR images with fat signal suppression in 7 cases, and a CT scan in 1 case. Histological study of a calcified disk from an anatomical specimen of an ankylosed lumbar spine resulting from ankylosing spondylitis was examined.Results The signal intensity of the disks was similar to that of the bone marrow or of perivertebral fat both on T1-weighted MR images and on all sequences, including those with fat signal suppression. In one of these disks, a strongly negative absorption coefficient was focally measured by CT scan, suggesting a fatty content. The histological examination of the ankylosed calcified disk revealed the presence of well-differentiated bone tissue and fatty marrow within the disk.Conclusion The high signal intensity of some calcified intervertebral disks on T1-weighted MR images can result from the presence of fatty marrow, probably related to a disk ossification process in ankylosed spines.     

MRI of the axial skeletal manifestations of ankylosing spondylitis

Magnetic resonance imaging (MRI) is a valuable tool in the imaging and assessment of patients with ankylosing spondylitis. MRI can demonstrate the acute and chronic changes of sacroiliitis, osteitis, discovertebral lesions, disc calcifications and ossification and arthopathic lesions, which characterize the disease, as well as the complications, which include fracture and the rare cauda equina syndrome. This article reviews the range of MRI findings commonly seen within the axial skeleton in patients with this condition.     

强直性脊柱炎的急性反应物研究进展

血清淀粉样蛋白A、基质金属蛋白酶、C反应蛋白等生物标记物通过炎性因子或其自身抑制物等多种炎性物质调节在机体内的表达,作用机制在诊断和治疗强直性脊柱炎(AS)过程中已愈发明晰。血清淀粉样蛋白A、基质金属蛋白酶表达水平在判定AS活性强度和监测治疗发挥了重要作用,其特异性要强于C反应蛋白和红细胞沉降率,是最具有潜力的功效蛋白。现就对近年来医学界对AS的临床检验生物标记物——急性期反应物的研究进展做一综述。     

强直性脊柱炎相关抗原HLA—B2704基因克隆

目的 对ＨＬＡ－Ｂ２７０４的编码基因进行克隆。方法 通过酚提法获取基因组ＤＮＡ,用ＥｃｏＲⅠｇ／Ｌ琼脂糖凝胶分离目的基因片段,采用内闰素末端标记的寡核苷酸探针对重组体噬斑转膜原位杂交,筛选阳性克隆,并进一步克隆化,用Ｗｉｚａｒｄ λＤＮＡ纯化系统试剂盒撮以纯化λＤＮＡ。结果 经酚提法获取基因组ＤＮＡ浓度为０．。８ｇ／Ｌ,Ｄ２６０／Ｄ２８０为１．７５,经高盐洗脱和乙醇纯化法获取的ＤＮＡ浓度为０．１６     

人类白细胞抗原-B27与强直性脊柱炎的相关性分析

目的 探讨人类白细胞抗原-B27(HLA-B27)检测在强直性脊柱炎(AS)早期诊断中的临床价值.方法 使用序列特异性引物-聚合酶链式反应(PCR-SSP)法对500例健康体检者(非AS对照组)、360例AS疑似患者(AS疑似组)和100例AS患者(AS组) 进行HLA-B27抗原检测.结果 非AS对照组、AS疑似组和AS组的HLA-B27阳性率分别为3.3%、 48.9%和92.5%,AS组、AS疑似组的HLA-B27阳性率明显高于非AS对照组(P<0.01),AS组的HLA-B27阳性率明显高于AS疑似组(P<0.01).结论 HLA-B27抗原与AS疾病相关,检测HLA-B27抗原对疑似AS患者的早期诊断有重要意义. Abstract： Objective To explore the clinical value of HLA-B27 in patients with ankylosing spondyfitis. Methods Using PCR-SSP to detect the HLA-B27 of 500 healthy people (non-AS group),360 presumed AS patients (suspectable group) and 100 AS patients(AS group). Results The positive rates of HLA-B27 of non-AS group, suspectable group, AS group were 3.3%,48.9% and 92.5%, respectively. The positive rate of HLA-B27 of AS group and suspectable group was obviously higher than that in non-AS group (P＜0.05). The positive rate of HLA-B27 of AS group was obviously higher than that in suspectable group (P＜0.05). Conclusions There is positive correlation between AS and HLA-B27.It is very important for the early diagnosis of AS.     

六味地黄汤加味治疗强直性脊柱炎的临床研究

目的观察六味地黄汤加味治疗肝肾不足、湿热痹阻型强直性脊柱炎（As）的疗效和安全性。方法本研究采用临床随机对照试验方法。将64例符合标准的患者随机分成两组。治疗组：32例,口服六味地黄汤加味;对照组：32例,口服甲氨喋呤＋柳氮磺吡啶,两组疗程均为3个月。结果经治疗,两组晨僵持续时间、Schober实验、胸廓扩张度、血沉（ESR）及C反应蛋白（CRP）等指标较治疗前均显著降低（P〈005）,并且治疗组改善程度明显大于对照组（P〈0．05）;治疗组不良反应发生率明显少于对照组（P〈0．05）。结论六味地黄汤加味是治疗肝肾不足、湿热痹阻型强直性脊柱炎安全而有效的方法。