强直性脊柱炎误诊的文献计量学分析

目的 通过对与强直性脊柱炎(AS)误诊相关的文献进行分析,了解AS误诊情况,提高早期诊断率。方法研究1989—2020年收录在中国期刊全文数据库(CNKI)中与AS误诊相关的文献,分析AS误诊的特征以及容易误诊的疾病类型。结果 ①初步筛选出与AS误诊相关的文献216篇,误诊病例数为7503例。有164篇文献是AS误诊为其他疾病,误诊病例共7328例;有53篇文献是其他疾病误诊为AS,误诊病例共175例。部分患者在就诊时被多次误诊。②1989年首篇关于AS误诊的病例被报道,2006年达到误诊病例高峰期;在AS的误诊病例中,“AS误诊为其他疾病”的病例相对较多;“其他疾病误诊为AS”的病例相对较少。③在诊断过程中,容易与AS相混淆的是“风湿性关节炎”,其次是“类风湿性关节炎”“腰椎间盘突出”“腰肌劳损”等疾病。结论 容易与AS相混淆的疾病种类繁多。病因不清,发病隐匿,诊断标准欠完善,缺乏比较敏感、能反映早期病变的诊断技术,临床医生对AS认识不足等是该病容易误诊的重要原因。由于认识水平的限制,临床医生需要提高诊疗水平,结合患者的症状、体征,运用影像学、实验室检查等多种方式综合分析、深入诊断,与其他多种疾病相鉴别,避免误诊。

Bibliometric analysis of misdiagnosis of ankylosing spondylitis

Objective To understand the misdiagnosis of AS and improve the early diagnosis rate by analyzing the literature related to the misdiagnosis of ankylosing spondylitis(AS).Methods The literature related to AS misdiagnosis included in the China Academic Journal Full-text Database(CNKI) from 1989 to 2020 were studied,and the characteristics of AS misdiagnosis and the types of diseases easily misdiagnosed were analyzed.Results 1.216 documents related to misdiagnosis of AS were initially screened,and the number of misdiagnosed cases was 7503.One hundred sixty-four documents misdiagnosed AS as other diseases,with a total of 7328 misdiagnosed cases.Fifty-three documents misdiagnosed other diseases as AS,with 175 misdiagnosed cases.Some patients were misdiagnosed many times during treatment.2.The first case of misdiagnosis of AS was reported in 1989,and the peak of misdiagnosed cases reached in 2006.Among the misdiagnosed cases of AS,there were relatively more cases of AS misdiagnosed as other diseases,relatively few cases of other diseases misdiagnosed as AS.3.In the diagnosis process,AS easily confused with rheumatoid arthritis,followed by rheumatoid arthritis,lumbar disc herniation,lumbar muscle strain and other diseases.Conclusion There are many kinds of diseases that are easily confused with AS.Unclear etiology,insidious disease,imperfect diagnostic criteria,lack of sensitive diagnostic techniques that can reflect early lesions,and lack of understanding by clinicians of AS are important reasons for the misdiagnosis of the disease.Due to the limitation of the level of understanding,clinicians need to improve the level of diagnosis and treatment,combined with the symptoms and signs of patients,use imaging,laboratory examination and other methods to comprehensively analyze and make in-depth diagnosis,and to differentiate from other diseases to avoid misdiagnosis.Due to the limitation of the level of understanding,clinicians need to improve the level of diagnosis and treatment,to comprehensively analyze and make in-depth diagnosis combining the symptoms and signs of patients using imaging,laboratory examinations and other methods,and to differentiate from other diseases to avoid misdiagnosis.