强直性脊柱炎2261例流行特征及功能状态现状分析

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2261份.结果2261例AS病人中,男性病人共有1873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2064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(χ2=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1782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 2261 AS patients.Re-sults Among the 2261 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,P=0.041).There were 479 cases of juvenile ankylosing spondylitis (JAS)and 1782 cases of adult ankylosing spondylitis (AAS).There were significant differences between the two groups in Schobertest (t=1.99,P=0.047),occipitalwallgap(t=2.67,P=0.008),degreeofbackache(t=2.28,P=0.023).Conclusions ASismain-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.What's more,HLA-B27 positive patients should be screened early too.There are great differ-ences between JAS and AAS in clinical features and functions.