男女性强制性脊柱炎临床特征比较

摘要

Objective To investigate the clinical characteristics of male and female patients with ankylosing spondylitis and the reasons that could explain the differences between them.Methods A retrospective analysis which contains 157 cases of men and 43 cases of women from Department of 2nd Rheumatology and Immunology of Shengjing Hospital of China Medical University from Novermber 2012 to October 2016 was performed.The clinical features, laboratory examinations, and imaging features of the patients with ankylosing spondylitis were compared and analyzed using t test, chi-square test with the software SPSS 22.0.Results Age at onset in women was later than that in men(P=0.034).There was a higher proportion of male patients with inflammatory back pain as initial manifestation[84.71%(133/157)vs.67.44%(29/43),P=0.015], and the number of extra-articular arthritis as first symptoms presented more in female than in male patients [12.74%(20/157)vs.30.23%(13/43),P=0.010].The incidences of extra-articular arthritis with hand joint, knee joint and elbow joint involved were higher in women than in man[2.5%(4/157)vs.16.3%(17/43),22.3%(35/157)vs.46.5%(20/43),1.9%(3/157)vs.9.3%(4/43),3.8%(6/157)vs.11.6%(5/43),P values were 0.002, 0.003, 0.040, 0.047].Compared to men, women had higher C-reaction protein[69.4%(109/157)vs.41.9%(18/43),P=0.001].A high rate of sacroiliitis Ⅱ level among women and a high rate of sacroiliitis level Ⅳ among men were observed[16.6%(26/157)vs.32.6%(14/43),17.2%(27/157)vs.4.7%(2/43),P=0.030, P=0.049].Conclusion Compared to women, the onset of ankylosing spondylitis is earlier and more severe in men.%目的 探讨男性与女性强直性脊柱炎(ankylosing spondylitis,AS)临床特征及两者之间差异的可能原因.方法 回顾性对比分析2012年11月至2016年10月在中国医科大学附属盛京医院第二风湿免疫科住院的157例男性AS患者及43例女性AS患者的临床资料,采用SPSS 22.0软件,通过t检验或卡方检验对纳入研究患者临床特征,相关实验室和影像学检查结果进行分析比较.结果 女性发病年龄较男性晚(P=0.034),以炎性背痛为首发症状男性多于女性[84.71%(133/157)vs.67.44%(29/43),P=0.015],以外周关节炎为首发症状女性则多于男性[12.74%(20/157)vs.30.23%(13/43),P=0.010].疾病累及手关节、膝关节、肘关节及踝关节的外周关节炎发生率女性明显高于男性[分别为:2.5%(4/157)vs.16.3%(7/43),22.3%(35/157)vs.46.5%(20/43),1.9%(3/157)vs.9.3%(4/43),3.8%(6/157)vs.11.6%(5/43),P值分别为0.002、0.003、0.040、0.047].C反应蛋白增高男性多于女性[69.4%(109/157)vs.41.9%(18/43),P=0.001].骶髂关节炎Ⅱ级发生率女性高于男性,男性患者骶髂关节炎Ⅳ级发生率高于女性,两者差异均有统计学意义[分别为:16.6%(26/157)vs.32.6%(14/43),17.2%(27/157)vs.4.7%(2/43),P=0.030、P=0.049].结论 男性AS患者与女性AS患者相比,发病年龄早,病情相对更重.