摘要
目的探讨强直性脊柱炎(ankylosingspondylitis,AS)伴发葡萄膜炎患者的临床特征,减少临床误诊或漏诊率。方法回顾分析2023年3月~6月在哈尔滨医科大学附属第一医院就诊的68例AS患者的临床资料,其中葡萄膜炎组31例、非萄萄膜炎组37例。行人类白细胞抗原B-27(human leukocyte antigen B-27,HLA-B27)、血沉(erythrocyte sedimentation rate,ESR)、C反应蛋白(C-reactive protein,CRP)和骶髂关节CT、裂隙灯检查,记录AS疾病活动性评分(Bath Ankylosing Spondylitis Disease Activity Index,BASDAI评分)、疾病功能性评分(Bath AS Function Index,BASFI)。结果AS伴发葡萄膜炎患者HLA-B27阳性率为80.65%,与非葡萄膜组(78.38%)比较差异无统计学意义(P>0.05),AS伴发葡萄膜炎患者ESR、CRP升高,与非葡萄膜炎组比较差异有统计学意义(P<0.05);葡萄膜炎组各项评分均大于非葡萄膜炎组,但两组间仅BASFI评分差异有统计学意义(P<0.05)。结论AS患者伴发葡萄膜炎并不少见,对眼科门诊出现的中青年男性单眼部葡萄膜炎患者,应注意询问是否存在腰骶部疼痛等相应症状,并行相关检查以排除AS,减少漏诊率、误诊率。
Objective To explore the clinical characteristics of patients with ankylosing spondylitis(AS)accompanied by uveitis and reduce the rate of misdiagnosis or missed diagnosis.Methods A retrospective analysis was conducted on the clinical data of 68 AS patients who visited the First Affiliated Hospital of Harbin Medical University from March to June in 2023,there were 31 cases in the uveitis group and 37 cases in the non uveitis group.Human leukocyte antigen B-27(HLA-B27),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),sacroiliac joint CT,slit lamp examination were detected,and Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)and Bath AS Function Index(BASFI)were recorded.Results The positive rate of HLA-B27 in patients with AS accompanied uveitis was 80.65%,and there was no statistically significant difference compared with the non uveal group(78.38%,P>0.05).ESR and CRP in patients with AS accompanied uveitis increased,and there was a statistically significant difference compared with the non uveal group(P<0.05);The scores of the uveitis group were higher than those of the non uveitis group,but there was only a statistically significant difference in BASFI scores between two group(P<0.05).Conclusion It is not uncommon for AS patients to have uveitis.For middle-aged and young male patients with single eye uveitis who appear in ophthalmic clinics,attention should be paid to inquiring if there are corresponding symptoms such as lumbosacral pain,and relevant examinations should be conducted to exclude AS,in order to reduce the rate of missed diagnosis and misdiagnosis.
作者
吴振平
刘雪梅
WU Zhen-ping;LIU Xue-mei(Department of Rheumatology and Immunology,The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China)
出处
《哈尔滨医科大学学报》
CAS
2023年第6期599-601,共3页
Journal of Harbin Medical University
关键词
强直性脊柱炎
葡萄膜炎
诊断
临床特征
ankylosing spondylitis
uveitis
diagnosis
clinical characteristics
