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未分化脊柱关节病83例临床分析

Clinical analysis of 83 cases of undifferentiated spondyloarthropathies

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【作者】 张文孙维生张帆张乃峥

【Author】 ZHANG Wen ,SUN Weisheng,ZHANG Fan,et al. Department of Rheumatology,Peking Union Medical College Hospital,Beijing 100730,China

【机构】 中国医学科学院中国协和医科大学北京协和医院风湿免疫科广东省潮州市中心医院黑龙江省鸡西矿务局总医院

【摘要】 目的 了解未分化脊柱关节病 (uSpA)的发病情况及临床特点。方法 收集半年内就诊于门诊的 10 2例血清阴性脊柱关节病患者 ,其中 83例属uSpA ,均不符合国际上通用的强直性脊柱炎 (AS)或其他肯定的血清阴性脊柱关节病 (如银屑病性关节炎、瑞特综合征、肠病性关节炎等 )的诊断标准 (如修订的纽约标准、美国风湿病学学会分类标准 ) ,对此 83例进行了临床分析。结果 uS pA患者男女比例为 1 6∶1,女性比例较AS组明显高 ,平均年龄 2 8 8岁 ,平均病程 3 1年。临床症状较AS轻 ,均无腰椎活动受限 ;uSpA组患者HLA B2 7阳性率低于AS组 ;有 4例晚起病的 (5 0岁以后 )AS患者 ;不一定有骶髂关节炎 ;普通X线及CT诊断骶髂关节炎者分别占 34 %和 73%。 89 1%符合Amor标准 ,85 6 %符合欧洲脊柱关节病研究组 (ESSG)标准。结论 uSpA在血清阴性脊柱关节病中占很大比重 ,临床工作中应给予足够的重视。推荐用Amor和ESSG标准进行诊断。该病的治疗和转归还有待于长期的随诊观察。

【Abstract】 Objective To substantiate the prevalence,clinical features and diagnosis of undifferentiated spondylarthropathies (uSpA).Method Within half a year time.102 patients with seronegative spondylarthropathies were registered in rheumatology outpatient clinic of Peking Union Medical College Hospital,among which 83 uSpA were diagnosed.Results All the uSpA patients had shorter disease history and milder clinical manifestations,and all did not fulfill the commonly used diagnostic criteria for ankylosing spondylitis and other distinct seronegative spondyloarthropathy like Reiter′s syndrome,psoriatic arthritis etc.89 1% and 85 6% of the uSpA patients fulfilled the Amor and ESSG criteria respectively.Conclusion uSpA is a very common condition and constitutes a major group of seronegative spondylarthopathies.It is recommended that clinicians should pay due attention to uSpA and Amor or ESSG criteria appear to be quite useful for diagnosis of them.Treatment and outcome of uSpA need prolonged follow up studies.

  • 【文献出处】 中华风湿病学杂志 ,CHINESE JOURNAL OF RHEUMATOLOGY , 编辑部邮箱 ,2000年04期
  • 【分类号】R593
  • 【被引频次】21
  • 【下载频次】305
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