类风湿关节炎合并强直性脊柱炎的临床及影像学特点  

CLINICAL AND IMAGING FEATURES OF RHEUMATOID ARTHRITIS WITH ANKYLOSING SPONDYLITIS

作　　者：冯波 马焕焕 王丽芹 赵磊[1] 潘琳[1] 董静[1] FENG Bo;MA Huanhuan;WANG Liqin;ZHAO Lei;PAN Lin;DONG Jing(Department of Rheumatology,the Affilited Hospital of Qingdao University,Qingdao 266003,Chin)

机构地区：[1]青岛大学附属医院风湿免疫科,山东青岛266003 [2]青岛市胶州中心医院

出　　处：《青岛大学学报（医学版）》2018年第4期468-471,共4页Journal of Qingdao University(Medical Sciences)

摘　　要：目的探讨类风湿关节炎(RA)合并强直性脊柱炎(AS)临床及影像学特点,从而为RA合并AS的早期诊断及治疗提供帮助。方法回顾性分析2010—2016年在青岛大学附属医院风湿免疫科诊断为RA合并AS的22例住院病人的临床资料,并与同期住院的25例RA和25例AS病人进行比较。结果 RA合并AS病人占RA的1.76%,占AS的3.74%,占两者总数的1.20%。RA合并AS病人以中年女性多见,临床表现为全身对称性外周及中轴关节炎。RA合并AS组病人血红细胞沉降率和C反应蛋白水平高于其他两组(F=6.826、10.756,P<0.01),HLA-B27抗体阳性率低于AS组(χ~2=4.060,P<0.05)。RA合并AS组影像学特征为RA和AS的典型改变并存。结论 RA合并AS临床并不少见,疾病炎性活动度较高,影像学表现与RA和AS相似,临床医师易漏诊,应加强对该疾病的早期诊断。Objective To examine the clinical and imaging features of rheumatoid arthritis（RA）with ankylosing spondylitis（AS）,and to provide insight into the early diagnosis and treatment of the disease. Methods The clinical data of 22 inpatients with RA complicated by AS in Department of Rheumatology,The Affiliated Hospital of Qingdao University,from 2010 to2016 were reviewed.These patients＇ data were then compared with the clinical data of 25 randomly selected RA patients and 25 AS patients,who were also treated in the same department within the same period. Results The cases of RA with AS accounted for1.76% of RA patients,3.74% of AS patients,and 1.20% of total RA and AS patients.The disease was more common among middle-aged women.The common clinical manifestations were systemic symmetrical peripheral and axial arthritis.Compared with the RA and AS groups,the RA with AS group had significantly higher erythrocyte sedimentation rate and C-reactive protein level（F=6.826 and 10.756,respectively,both P〈0.01）and a significantly lower positive rate of HLA-B27 antibody（χ~2=4.060,P〈0.05）.The imaging features of the RA with AS group were similar to the pathological changes typically found in RA and AS. Conclusion RA with AS is not an uncommon clinical disease.This disease has high inflammatory activity,and its imaging features are similar to those of RA and AS combined.Since clinicians often fail to identify the disease,early diagnosis of the disease must be reinforced.

关 键 词：关节炎 类风湿 脊柱炎 强直性 疾病特征 

分 类 号：R593.2[医药卫生—内科学]