摘要
目的：观察柳氮磺胺吡啶（ＳＳＺ）、氨甲喋呤（ＭＴＸ）、体疗对强直性脊柱炎（ＡＳ）的治疗效果。对幼年ＡＳ及成人ＡＳ误诊原因进行临床分析。方法：１８例ＡＳ患者服用ＳＳＺ（２．０ｇ／ｄ），关节受累数多、病情严重者加用ＭＴＸ（１５ｍｇ／Ｗ），均配合体疗，观察６月～２０月，治疗前后各临床实验室指标对比用ｔ检验。结果：治疗后晨僵、关节肿痛数、血沉、Ｃ－反应蛋白、血清ＩｇＡ水平和ｓｃｈｏｂｅｒ试验（Ｐ＜０．０１和Ｐ＜０．０５）均显著改善，扩胸试验无明显变化（Ｐ＞０．０５）。临床缓解和显效、有效、无效率分别为３３．３％、２７．８％、３３．３％、５％。服ＳＳＺ达临床缓解平均时间９个月，服ＳＳＺ＋ＭＴＸ达临床缓解平均时间８个月，坚持体疗者达临床缓解时间较非坚持者缩短１．３月。疗程一年以上者，８５．７％骶髂关节病变停止进展。结论：ＳＳＺ治疗ＡＳ有确切疗效，加用ＭＴＸ可提高疗效，副作用无明显增加，疗程一年以上疗效更确切。体疗时间与疗效成正比。本文还分析易被误诊的幼年ＡＳ，其外周关节炎常为首发症状的临床表现，诊断依据病史、家族史、ＨＬＡ－Ｂ２７等。及时摄骨盆平片了解骶髂关节情况可提高成人ＡＳ早期诊断率，减少误诊。
Objective:The curative effects for Ankylosing Spondylitis(AS) were observed by using Sulfasalazine(SSZ).Methotrexate(MTX) and exercise.The main cause of misdiagnosis for Juvenile AS(JAS) and aduct AS were analysed.Methods:Einhteen Patients with AS were treated with SSZ(2.0g/d),and with SSZ and MTX in severe Peripheral joint arthritis during six to twenty months.ALL patients exerised in formal instruction under the supervision of a therapist.Results: The morning stiffness,the number of joint pains,ESR,CRP and schober test were markedly improved(P<0.01 and P<0.05),33.3% of patients were in clinical remission,27.8% markdely improved,33.3% improved and 5% had no change.The average time to reach clinical remission with SSZ was nine months,with SSZ and MTS was eight months.Conclusion:SSZ is an effective drug in the treatment of AS,It is more effective for serious patients by using SSZ and MTX.The more time the patieats exercise,the larger benefit will be made.To avoid misdiagnosis one of the early important signs in JAS is peripheral arthritis,and in adult AS radiographic sign of sacroiliac joints.
出处
《山西临床医药》
1999年第3期181-183,共3页
Shanxi Clinical Medicine
关键词
强直性脊柱炎
柳氮磺胺吡啶
氨甲喋呤
药物疗法
Spondylitis ankylosing
Sulfasalazine
Methotrexate
Exercise
Analysis of misdiagnosis
