幼年与成年强直性脊柱炎的对比研究

Juvenile ankylosing spondylitis: clinical analysis of 59 cases

  • 摘要: 作者分析了59例幼年发病的强直性脊柱炎(JAS)的临床表现及实验室检查结果,并与49例成年发病的强直性脊柱炎(AS)患者进行比较,发现JAS与AS最显著的差异在于前者以特征性的腰骶部疼痛与发僵起病者明显少于AS组(P<0.01);JAS组全部出现外周关节受累,而AS组可有部分患者不出现;JAS组肌腱端病比AS多见。本文还简要讨论了JAS的诊断、治疗及预后。

     

    Abstract: The clinical and laboratory manifestations of 59 patients with juvenile ankylosing spondylitis (JAS) were analysed and compared with those of 49 ankylosing spondylitis (AS) patients. The results showed that the age of onset in JAS was 4 to 16 years with a peak of 12 to 15 years. The male to female ratio was 19∶1. Joints of the lower extremity were much more commonly affected than the upper. Three fourth of the patients had a polyarticular onset with an asymmetrical pattern of peripheral joint involvenent. The positive rate of HLA B27 of JAS patients was 88.1% and virtually all patients presented no rheumatoid factor and anti nuclear antibody. The ocular, cardiac and pulmonary involvement of JAS patients were similar to those of AS patients. Our study indicated that the most prominant differences between JAS and AS were∶1. Fewer patients with JAS had pain or stiffness in the lumbarsacral spine at onset (P <0.01);2. With few exceptions, patients with JAS eventually developed peripheral joint diseases if they did not have them at onset; 3. Enthesitis occurred with greater frequency than in adult onset AS. The diagnosis, treatment and prognosis of JAS were also discussed briefly.

     

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