强直性脊柱炎2261例流行特征及功能状态现状分析  

Clinical features and functional status of 2261 patients with ankylosing spondylitis

作　　者：韩仁芳 陈梦雅[1,2] 刘瑞[1,2] 张旭[1,2] 王蒙蒙[1,2] 夏青[1,2] 胡星星[1,2] 徐胜前[3] 徐健华[3] 帅宗文[3] 潘发明[1] 

机构地区：[1]安徽医科大学流行病与卫生统计学系,安徽合肥230032 [2]安徽省重大自身免疫性疾病重点实验室,安徽合肥230032 [3]安徽医科大学第一附属医院风湿免疫科,安徽合肥230022

出　　处：《安徽医药》2017年第1期73-77,共5页Anhui Medical and Pharmaceutical Journal

基　　金：国家自然科学基金(81273169,81573218)

摘　　要：目的了解强直性脊柱炎(AS)病人的流行特征和功能状态现状,以期为AS的早期诊断和治疗提供基础资料。方法对AS病人进行回顾性调查分析,共收集到符合标准的调查表2 261份。结果 2 261例AS病人中,男性病人共有1 873例,女性病人共有388例,男女性别之比为4.83∶1。病人平均发病年龄为(23.6±8.7)岁,男性病人发病年龄平均为(23.3±8.9)岁,女性病人发病年龄平均为(25.2±7.6)岁,性别间差异有统计学意义(t=3.21,P=0.001)。病程中位数4.00(2.00,8.00),男性病人病程中位数是4.00(2.00,9.00),女性病人病程中位数是3.00(1.00,6.00),性别间差异有统计学意义(Z=3.32,P=0.001)。AS病人首发症状主要以腰背痛或不适(中轴)症状为主,共739例,占42.7%。在本次调查中,HLA-B27阳性病人2 064例,占91.3%,其中男性病人阳性率为92%,女性病人阳性率为88%,性别间差异有统计学意义(χ~2=4.17,P=0.041)。幼年型强直性脊柱炎(JAS)病人479例,成年型强直性脊柱炎(AAS)病人1 782例,两组疾病活动指数比较结果:两组的Schober检查(t=1.99,P=0.047)、枕墙距(Z=2.67,P=0.008)、总体背痛程度(t=2.28,P=0.023)差异有统计学意义。结论 AS主要在男性青壮年中发病,尤其是有中轴关节或外周关节症状等表现应及早筛查,HLA-B27阳性者也应做早期筛查。JAS与AAS在临床特征和功能状态上差别较大。Objective To explore the epidemiological characters and functional status of ankylosing spondylitis（ AS） patients and to pro-vide basic data for early diagnosis and treatment of AS. Methods Retrospective analysis was made of totally 2 261 AS patients. Re-sults Among the 2 261 patients with AS,the male to female ratio was 4. 83：1. The average onset age of the patients was 23. 6 ± 8. 7 years old （ male： 23. 3 ± 8.9 years old; female： 25. 2 ± 7. 6 years old）. There was a significant difference in the onset age of AS between male and female patients （t=3.21,P=0. 001） . The median of disease duration [ M（ P25 ,P75 ） ] was 4. 00 （ 2. 00,8.00） years with a significant difference between male and female （Z = 3. 32,P = 0. 001） . There were 42. 7% （739 cases） of the patients complaining low back pain or discomfort as the first symptom. In the survey, HLA-B27 positive patients accounted for 91. 3% （ male ： 92% ; female 88% ） , with statistically significant difference in gender（χ2 = 4. 17 = 0. 041） . There were 479 cases of juvenile ankylosing spondylitis（JAS）and 1 782 cases of adult ankylosing spondylitis （ AAS）. There were significant differences between the two groups in Schobertest （t = 1.99 = 0.047） ,occipital wall gap（ t = 2. 67 = 0.008） ,degree of backache（t= 2. 28 = 0.023）. Conclusions AS is main-ly found in male young adults. Early screening should be conducted especially when there are symptoms of peripheral joint symptoms or low back discomfort and other symptoms. Whats more,HLA-B27 positive patients should be screened early too. There are great differ-ences between JAS and AAS in clinical features and functions.

关 键 词：脊柱炎 强直性 流行特征 功能指数 

分 类 号：R593.23[医药卫生—内科学]