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未分化脊柱关节病83例临床分析 |
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张文 孙维生 张帆 张乃峥
【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102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 uSpA患者男女比例为1.6∶1，女性比例较AS组明显高，平均年龄28.8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-B27阳性率低于AS组；有4例晚起病的(50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。
【关键词】 未分化血清阴性脊柱关节病； 诊断
Clinical analysis of 83 cases of undifferentiated spondyloarthropathies
ZHANG Wen,SUN Weisheng,ZHANG Fan,et al.
Department of Rheumatology,Peking Union Medical College Hospital,Beijing 100730,China
【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.
【Key words】 Undifferentiated spondylarthropathies; Diagnosis
血清阴性脊柱关节病(seronegative spondyloarthropathy，SpA)是一大类疾病，包括强直性脊柱炎(AS)、瑞特综合征、银屑病性关节炎、肠病性关节炎、反应性关节炎等。这类疾病的临床表现多种多样，症状有很大重叠，病变程度亦轻重[1] [2] 下一页
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