【摘要】 目的 探讨基层地区强直性脊柱炎(AS)患者髋关节病变的临床特点及危险因素。方法 纳入于临泉县人民医院确诊的AS患者107例，根据是否合并髋关节受累分为髋关节受累组(47例)与非髋关节受累组(60例)。比较两组患者一般临床资料、实验室检查结果与影像学检查结果。采用多因素logistic回归分析评估AS患者合并髋关节病变的影响因素。结果 与非髋关节受累组比较，髋关节受累组患者BMI、中轴关节首发患者比例更低；AS病程、病程≥10年、发病年龄≤16岁患者比例、延误治疗时间、C反应蛋白(CRP)、AS疾病活动评分(ASDAS)更高；与非髋关节受累组相比，髋关节受累组0～3级患者比例更低，4级患者比例更高(P<0.05)。多因素logistic回归分析结果显示，发病年龄≤16岁、病程≥10年、碱性磷酸酶(ALP)、骶髂关节炎放射学分级、ASDAS均为AS合并髋关节病变的危险因素；BMI是其保护因素(P<0.05)。病程越长，AS患者髋关节受累的发生率越高(P<0.05)。结论 基层地区应更加关注低BMI、发病年龄≤16岁、病程≥10年、高ALP、骶髂关节炎分级严重和高ASDAS的AS患者髋关节受累情况。更多还原

【Abstract】 Objective To investigate the clinical characteristics and risk factors of hip joint involvement in patients with ankylosing spondylitis(AS) in grassroots areas.Methods A total of 107 AS patients diagnosed at Linquan County People’s Hospital were enrolled and divided into hip involvement group(47 cases) and non-hip involvement group(60 cases) according to the presence or absence of hip involvement.General clinical data, laboratory findings, and imaging results were compared between the two groups.Multivariate logistic regression analysis was employed to evaluate influencing factors for AS combined with hip involvement.Results Compared with non-hip involvement group, BMI and the proportion of the first axial joint in hip involvement group were lower.The duration of AS,the proportion of patients with disease duration ≥10 years, onset age ≤16 years, delayed treatment time, C-reactive protein(CRP) and ankylosing spondylitis disease activity score(ASDAS) were higher.Compared with the non-hip involvement group, the proportion of patients with 0～3 grade was lower, and the proportion of patients with 4 grade was higher in hip involvement group(P<0.05).Multivariate logistic regression analysis showed that onset age ≤16 years old, disease duration ≥10 years, alkaline phosphatase(ALP),radiological grade of sacroiliitis, and ASDAS score were risk factors for AS with hip joint lesion. BMI was protective factor.The longer the course of disease, the higher the incidence of hip involvement in AS patients(P<0.05).Conclusion More attention should be paid to AS patients with low BMI,onset age ≤16 years, disease duration ≥10 years, high ALP,severe grade of sacroiliitis and high ASDAS score in grassroots areas.更多还原