【摘 要】 目的 了解本地区强直性脊柱炎(AS)的临床特点，提高诊治水平。方法 回顾性分析1983～1997年370例专科门诊诊治的AS病人的一般临床资料、治疗及随访结果。结果 94%的病例隐匿发病。腰痛、外周关节炎、“4”字试验阳性、骶髂关节压痛和腰椎压痛为常见症状和体征。骶髂关节受累程度、髋关节和脊柱受累均与病程有关；儿童AS髋关节受累与病程关系不大；也有病程16年但骶髂关节炎仍为Ⅱ级者。治疗头2年症状、体征改善较明显，以后改善不显著，但停药后多加重。治疗1、2和5年以上坚持率分别为34.6%、28.4%和10.3%。放射学随访变化与临床表现不一定平行。结论 AS的早期诊断有利于改善预后。坚持慢作用抗风湿药治疗有利于控制病情。疗效判定应随访3年以上，且有放射学依据。本病是一种异质性疾病，影响预后的因素尚待继续探讨。

Ankylosing spondylitisin Shantou： clinicalexperience in fifteen years

    ZENG Qingyu, CHEN Subiao, XU Jiezhou, et al.

    The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong515031

【Abstract 】 Objective Toevaluate the clinical features of ankylosing spondylitis (AS) in Shantou area and improvethe diagnostic level and therapeutic effect. Methods Clinical andlaboratory data, and the methods and effects of therapy were analyzed. Some patients werefollowed up. Results 94% of the cases had an insidious onset. Low backpain or discomfort, peripheral arthritis, positive “4” test and pressing tendernessover the sacroiliac joints and lumbar spine were the frequent symptoms and signs. Thedegree of sacroiliitis and involvement of hip and spine were related to the diseaseduration. However, hip joint involvement in juvenile onset AS did not relate to thedisease duration. Some cases with disease duration as long as 16 years still remained atⅡ of degree sacroiliitis. Clinical improvement was more obvious in the first two yearsof treatment. Although some patients came to a standstill condition after this period, yetthe disease activity might still relapse with withdrawal of the treatment. The rate ofadhering to the treatment for 1, 2, and over 5 years was 34.6%, 28.4%, and 10.3%respectively. The radiological changes frequently did not parallel with the clinicalmanifestations. Conclusion Early diagnosis is of importance inimproving the prognosis of AS and adherence to slow-acting anti-rheumatic drug therapy isbeneficial in disease controlling. A follow up of more than 3 years is necessary toestimate the therapeutic efficacy, and the radiological change is the key indicator. AS isa heterogenic disease and the risk factors for prognosis should be further studied.

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