脊柱关节病诊断和治疗的相关热点  

Hotspots on the diagnosis and management of spondyloarthropathies

作　　者：卿平英[1] 刘毅[1] 

机构地区：[1]四川大学华西医院风湿免疫科,四川成都610041

出　　处：《实用医院临床杂志》2011年第2期39-42,共4页Practical Journal of Clinical Medicine

摘　　要：脊柱关节病(SpA)是一大类高发病率、高致残率的风湿性疾病。如何减少误诊及提高早期诊断率仍是临床有待解决的难题。随着临床研究的深入及影像学检查如CT、MR I的普及,以往的Amor和ESSG SpA诊断标准已不能满足临床早期诊断的要求,ASAS近年发布了中轴型SpA最新分类标准,该标准既传承了以往标准IBP、骶髂关节影像学改变的SpA传统观念,同时也兼顾伴有HLA-B27(+)以及仅有SpA特征的早期SpA特殊人群,对避免SpA误诊及漏诊有重要意义。非甾体抗炎药及类固醇激素有良好的抗炎镇痛作用,但不能控制病情,仅少数的慢作用药及免疫抑制剂证实对SpA有效,生物制剂的问世是SpA治疗的里程碑。SpA应综合患者的具体情况进行个体化治疗。The spondyloarthropathies（SpA） is a group of rheumatic disease with relative high incidence.it is still a challenge to reduce misdiagnosis and missed diagnosis of SpA.The former diagnostic criteria will not satisfy the clinical needs.In 2009 ASAS has issued the newest classification criteria of axial spondyloarthropathies,it retained the traditional ideal of IBP and the imageology changes of sacroilitis,simultaneously emphasized the special clues including HLA-B27 and the other clinical characteristics of SPA.The non-steroidal anti-inflammatory drug and steroid hormone have the good anti-inflamatory function,but cannot control the disease progress,only minority of slow action drug and immunosuppressor is confirmed effective.Biological agents become the milestone in the treatment of SpA.

关 键 词：脊柱关节炎 诊断 治疗 强直性脊柱炎 银屑病性关节炎 肠病性关节炎 

分 类 号：R593.23[医药卫生—内科学]