Calin A, Fries J F
N Engl J Med. 1975 Oct 23;293(17):835-9. doi: 10.1056/NEJM197510232931701.
Ankylosing spondylitis is diagnosed once or twice in each 1000 males and one tenth as frequently in females, but the true prevalence is unknown. Indentification of genetic marker, HL-A W27, for susceptible persons has provided a tool facilitating epidemiologic studies and allowing identification of "control" populations without the marker. Evaluation by postal questionnaires, and pelvic radiography of 78 HL-A 27W-positive blood donors selected from a group of apparently healthy subjects revealed 14 who satisfied the criteria for definite ankylosing spondylitis. The prevalence was similar in both sexes. One hundred and twenty-six W27-negative controls matched for race, sex, and age failed to yield a single case. For a person of either sex with HL-A W27, there appears to be about a 20 per cent chance that ankylosing spondylitis will develop, suggesting a prevalence of 10 to 15 per thousand. Hitherto accepted figures may underestimate the frequency by a factor of 10 to 20.
强直性脊柱炎在每1000名男性中被诊断出一到两次，在女性中的诊断频率为男性的十分之一，但实际患病率尚不清楚。对于易感人群，遗传标记HL-A W27的识别提供了一种工具，便于进行流行病学研究，并能够识别出没有该标记的“对照”人群。通过邮寄问卷进行评估，并对从一组看似健康的受试者中选出的78名HL-A 27W阳性献血者进行骨盆X光检查，结果发现有14人符合确诊强直性脊柱炎的标准。男女患病率相似。126名在种族、性别和年龄上匹配的W27阴性对照者中未出现一例病例。对于携带HL-A W27的男性或女性而言，患强直性脊柱炎的几率约为20%，这表明每千人中的患病率为10至15例。此前公认的数据可能低估了发病频率，低估系数为10至20倍。
