幼年脊柱关节病误诊分析  

MISDIAGNOSTIC ANALYSIS OF JUVENILE-ONSET SPONDYLOARTHROPATHIES

作　　者：郭君[1] 楚海峰[1] 单鸣凤[1] 

机构地区：[1]吉林大学中日联谊医院儿科,吉林长春130031

出　　处：《河北医科大学学报》2009年第3期260-261,共2页Journal of Hebei Medical University

摘　　要：目的研究幼年脊柱关节病(juvenile-onset spondylo-arthropathics,JSpA)的早期临床表现,分析误诊原因。方法对 JspA 40例(男性37例,女性3例)患者进行回顾性分析。结果早期临床表现,以下肢非对称性关节炎发病16例占40.0%为①组,以单或双侧骶髂关节肿痛伴活动障碍者10例占25.0%为②组,以①+②两种形式发病9例占22.5%为③组,以手指或足趾肿痛+①发病2例占5.0%为④组,以脊柱或足趾痛+②发病3例占7.5%为⑤组。人类白细胞抗原-B_(27)检测36例,阳性33例占91.7%。发病初期诊为关节结核10例占25.0%,诊为股骨头坏死3例占7.5%,诊为幼年类风湿性关节炎少关节型27例占67.5%。结论 JspA 的早期临床表现不典型,易误诊。Objective Research the early clinical manifestations of juvenile-onset spondylo- arthropathies（JSpA） and analyze the reasons of misdiagnosis. Methods Forty cases of JSpA （male,37 cases; female,3 cases） were studied retrospectively. Results According to early clinical manifestations, joints of lower limbs were affected non-symmetricaly in 16/40（40%,①group）. Sacroiliac joint were affected in 10/40 （25%, ②group）. Both ① and ② were affected in 9/40 （22.5%,③group）.Hands and feet were affected ＋① in 2/40（5%,④group）. Spinal or feet were affected ＋ ② in 3/40 （7.5%, ⑤ group）. Analysis of human leukocyte antigen-B27 （ HLA-B27 ）, HLA-B27 was tested in 36/40,33/36 were positive（91.67%）. At the early stage of the disease,10 cases had been misdiagnosed as joint tuberculosis,accounting for 25 %;3 cases were misdiagnosed as osteonecrosis of the femoral head accouting for 7.5%; 27 cases were misdiagnosed as fewer joints of juvenile rheumatoid arthritis accounting for 67.5%. Conclusion Early clinical manifestation of JSpA is not typical,so JSpA is easily misdiagnosed.

关 键 词：脊柱疾病 关节疾病 误诊 

分 类 号：R725.9[医药卫生—儿科]