晚发强直性脊柱炎及其临床特点

目的　提高对晚发强直性脊柱炎 (LAS)的认识。方法　对 7例LAS临床资料进行研究 ,并与 175例成人、40例儿童发病强直性脊柱炎 (AAS与JAS)进行比较。结果　LAS发病 >45岁 ,男女发病率相仿 ,主要以外周关节症状发病 ,有不同程度腰椎压痛和活动受限 ,贫血与血沉升高多见 ,骶髂关节和髋关节X线损害严重 ,腰椎竹节样变多见。常合并其他疾病 ,误诊率高。结论　遇无中轴关节而有外周关节症状老年患者要提高LAS警惕性 ,及时做腰、骶髂、髋关节放射学检查 ,及早确诊。

Late onset ankylosing spondylitis and its clinical features

Objective To study the clinical features of late onset ankylosing spondylitis (LAS).Methods The clinical data of 7 patients with LAS were analyzed and compared with those of 175 cases of adult onset ankylosing spondylitis (AAS) and 40 cases of juvenile ankylosing spondylitis (JAS).Results LAS always occurred after one′s 45 years,the incidence rate of the male was similar to the female.Most of them had an episode on the periarticulatiion with lumbar vertebral tenderness and activity limitation to different degrees.Anemia and increase of erythrocyte sedimentation (ESR) were common.It could be found from the X ray plain film that lesions of sacroiliac joint and hip joint were severe,and lumbar spine syndesmophyte formation was common.Its misdiagnosis rate was high since always complicated with other diseases.Conclusion Attention should be paid to LAS in the old-aged patients which have peri-articular and no axis articular symptoms,and it is necessary to promptly perform radiological examinations of lumbar spine,sacroiliac joint and hip joint.