部分部队官兵类风湿关节炎及血清阴性脊柱关节病的流行病学调查  

Epidemiological investigation of rheumatoid arthritis and seronegative spondylarthritis in Chinese armed forces

作　　者：吴振彪[1] 朱平[1] 王宏坤[1] 郑朝晖[1] 卢宁[1] 贾筠[1] 丁进[1] 冷南[1] 刘玲[1] 张惠琴[1] 

机构地区：[1]第四军医大学西京医院临床免疫科,陕西西安710033

出　　处：《第四军医大学学报》2008年第18期1696-1699,共4页Journal of the Fourth Military Medical University

摘　　要：目的:调查类风湿性关节炎(RA)及血清阴性脊柱关节病(SpA)在不同地区不同兵种部队中患病及流行特点.方法:采用COPCORD询问表,对内陆平原地区、南疆干旱地区、北疆及青海寒冷高原地区及沿海潮湿地区,包括陆、海、空三军共21750人进行四级调查.初步诊断病例行X线、RF、抗CCP抗体、抗AKA抗体及HLA-B27检测.结果:RA患病率为0.966‰,SpA患病率4.87‰,其中强直性脊柱炎(AS)患病率为2.11‰,反应性关节炎(ReA)患病率为0.276‰,未分化脊柱关节病(USpA)患病率2.39‰,).RA,AS,USpA在海军中患病率高于其他兵种.RA在不同地域间患病率无统计学差别,AS在高原寒冷地区及沿海潮湿地区的患病率高于干旱地区及内陆地区,USpA在沿海潮湿地区的患病率高于干旱地区及内陆地区.结论:RA在部队的患病率显著低于普通人群,在海军中的患病率高于其他兵种.AS,USpA在部队的患病率接近普通人群.血清阴性脊柱关节病(SpA)在高原寒冷及潮湿环境地区部队的患病率增高.AIM： To investigate the prevalence of rheumatoid arthritis （RA） and seronegative spondyloarthritis （SpAs） in Chinese armed forces in different areas and its epidemiological characteristics. METHODS： Four phase survey was conducted in 21 750 Chinese soldiers （ army, navy and air forces from different areas）, including face-to-face interviews with standardized COPCORD questionnaires （Phase I screening） , further examination of the suspected cases, and ease identification with inflammatory joint and spine diseases （ phase Ⅱ）, identification of RA and USpA by more than two experienced doctors specializing in rheumatology, and further examination with X rays and laboratory detection of rheumatoid factors, anti-antikeratin antibody, anticyclic citrullinated peptide antibody, HLA-B27 （phase Ⅲ ）, and data analysis （phase Ⅳ ）. RESULTS： Among 21 750 soldiers, 21 cases of RA, 106 cases of SpAs were identified, with the prevalence of 0. 966%0 and 4.87%0, respectively. In 106 cases of SpAs, there were 46 cases of ankylosing spondylitis （AS）, and 52 cases of undifferentiated SpAs （ USpAs）, with the prevalence 2.11‰ and 2.39‰, respectively. Few cases of reactive arthritis （ReA） and Reiter＇s syndrome （RS） were identified （ n = 6, 1, respectively）. The prevalence of RA, AS and USpAs were higher in the navy force than in the army and air forces. Soldiers in cold and damp areas had higher prevalence rate than in the plain and dry areas. CONCLUSION： The prevalence rate of RA in Chinese soldiers is lower significantly than that in the civilians, while the prevalence rate of SpA （ especially AS and USpA） is similar to that in the civilians. The prevalence of RA, SpA （ AS and USpA） is influenced by environmental factors such as cold-ness and dampness.

关 键 词：关节炎 类风湿 血清阴性脊柱关节炎 患病率 军事人员 

分 类 号：R593.22[医药卫生—内科学]