强直性脊柱炎38例临床分析

目的，总结强直性脊柱炎（AS）的临床特点，提高诊治水平。方法：回顾性分析1991－1999年间诊治的38例AS病人的临床资料。结果38例AS中，男34例，女4例。平均发病年龄28岁，首发症状为慢性腰痛者29例占76．32％；关节外表现仅见虹膜炎4例占10．52％，骨贫正位片全部有骶髂关节炎占100％；HLA－B27阳性3．5例占92．10％，17例误诊占44．73％，治疗药物主要有非甾体类抗炎药（NSAIDs)，柳氮磺胺吡呤（SSZ），甲氨蝶呤（MTX），糖皮质激素等。结论AS多见于青年男性，其首发症状多为慢性腰痛，临床易误诊，骨贫正位片骶髂关节炎及HLA－B27阳性有助于早期诊断和治疗。

Clinical Analysis of Ankylosing Spondylitis(A Report of 38 Cases)

Objective: To analyze the clinical characters of ankylosing spondylitis (AS) and improve the effect of diagnosis and treatment of AS. Methods: The clinical data of 38 patients with AS diagnosed and treated from 1992 to 1999 were analyzed retrospectively. Results: Of the 38 patients, 34 were male and 4 female, the average age at onset of disease was 28 years old. Chronic back pain, as the initial symptom at onset was observed in 29 (76.31%); iritis, the only clinical feature other than signs of the joints, was observed in 4 (10.52%); pelycographic sacroiliitis, were shown in all 38 (100%) patients and HLA B27 was present in 35 (92.1%). Misdiagnosis was made in 17 (44.73%). The major drugs used for AS were NSAIDs SSZ, MTX, glucocorticoid etc. Conclusion: AS occurs more frequently in young men . In most patients with AS the initial symptom is chronic back pain and may be easily misdiagnosed. Sacroiliitis on pelycogram and positive HLA B27 test are helpful to early diagnosis and treatment of AS.