未分化脊柱关节病436例临床特点及转归

目的:了解未分化脊柱关节病(uSpA)的临床特点及发展规律。方法:选择2000年1月至2010年6月在中山大学附属第一医院风湿免疫科病房和门诊就诊的、资料完整的436例uSpA患者为研究对象进行临床资料搜集并随访。结果:436例患者其中男284例,女152例,男女性别比为1.9:1。患者年龄13～54岁,平均25±7岁,平均病程为(31±10.7)月。首发症状以腰背部疼痛最为多见(55.2%),其次为附着点部位、臀部、膝关节、髋关节疼痛,阳性率分别为47.7%,36.2%,31.2%和27.1%。经治疗随诊发现有74例(17.0%)症状消失,129例(29.6%)仍为uSpA,余233例(53.4%)转归为其他疾病。分化为可分类的SpA192例(44.0%),演变为其他风湿性疾病为41例(9.4%)。结论:未分化脊柱关节病临床表现多样,并容易向其他类型的脊柱关节病转化,需临床密切观察随访有利于早期诊断和治疗。

Clinical features and follow-up data of 436 cases of undifferentiated spondyloarthropathies

Objective To explore the clinical features and the developmental rules of undifferentiated spondyloarthropathies(uSpA).Methods The clinical,laboratory,and follow-up data in 436 patients with uSpA in the First Affiliated Hospital of Sun Yat-sen University from Jan 2000 to June 2010 were collected and analyzed.Results Among the 436 patients with uSpA,there were 284 male and 152 females,aged from 13 to 54(25±7) years,and the course of disease was(31±10.7) months.The chief symptoms were lumbar pain(55.2%) and enthesitis(47.7%).After the follow-up,the symptoms were disappeared in 74 patients(17.0%),remained to be uSpA in 129 patients,and developed to other diseases in 233 patients(including 192 cases with spondyloarthropathy in other differentiated subtype and 41 cases with other connective tissue disease).Conclusion USpA is a group of diseases with complex clinical characteristics.Some patients can develop to ankylosing spondylitis,psoriatic arthritis,or enteropathic arthropathy.So the uSpA patients should be observe and followed-up tightly.