强直性脊柱炎的临床、实验室与放射学关系的探讨

The research of the relationship between clinic, Lab and radiology change of AS

关键词:  强直性脊柱炎  骶髂关节  CT  X线平片

Key words:  ankylosing spondylitis  sacriliac articulation  CT  X-rays

摘要:

探讨强直性脊柱炎(AS)临床、实验室及放射学改变之间的关系。方法：确诊为AS的患者35例，测定其ESR及IgG、IgM、IgA和HLA-B27，并同时做骶髂关节平片和CT扫描，研究其相互关系。结果：本组双侧骶髂关节受累者达100%。HLA-B27阳性率90以上。35例中，10例平片诊断Ⅰ～Ⅱ级，CT诊断Ⅱ～Ⅲ级；15例平片诊断Ⅱ～Ⅲ级，CT诊断Ⅲ～Ⅳ级。AS骶髂关节炎分级越高，其临床表现、免疫学指标均加重，红细胞沉降率在Ⅱ～Ⅲ级中最快。结论：AS与HLA-B27高度相关。AS患者骶髂关节炎分级基本可反映病情程度。两性AS患者存在差异，女性病情轻，预后好。CT对AS骶髂关节炎的诊断较平片敏感一个级别。

Abstract:

To study the relationship between the clinic,Lab and radiology change of AS. Method:To assay ESR,IgG,IgM,IgA and HLA-B27,to make sacroiliac articulation X-rays and CT scan on 35 cases diagnosed.And to analyze their interrelation. Result:The percentage of both side sacroiliac articulation affected by AS of 35 cases was as high as 100%.10 cases were graded by X-rays to Ⅰ～Ⅱ guade,but were Ⅱ～Ⅲ grade by CT scan;15 cases were graded to Ⅱ～Ⅲ grade by X-rays,while were Ⅲ～Ⅳ grade by CT scan. The higher the grade of sacroiliac arthritis, the more serious the clinical manifestation and immunology index.And the ESR in Ⅱ～Ⅲ grade was the highest among all cases. Conclusion:It is believed that AS is highly connected with HLA-B27,the grade of sacroiliac arthritis by CT scan can reflect the degree of disease.The prognosis of female patient is better than the male, and the severity is also mild.