Bakland Gunnstein, Nossent Hans C, Gran Jan T
University Hospital Northern Norway, Tromsø, Norway.
Arthritis Rheum. 2005 Dec 15;53(6):850-5. doi: 10.1002/art.21577.
To determine the incidence and prevalence of ankylosing spondylitis (AS) over a prolonged period in the 2 northernmost counties of Norway, where HLA-B27 has a high prevalence in the population.
We conducted a cohort study of all patients registered with a diagnosis of AS between 1960 and 1993 at the University Hospital of Northern Norway, which is the sole rheumatology department serving these counties. We registered demographics, year of disease onset (clinical disease), and year of diagnosis (radiograph confirmation) for all patients. The date of onset of clinical disease in patients with AS was used in the calculation of incidence rates. Annual incidence and point/period prevalence rates were expressed per 100,000 adults. Primary AS was defined as AS in the absence of psoriasis or inflammatory bowel disease (IBD).
A total of 534 patients (75.1% male, mean age at clinical diagnosis 24.2 years, 93.0% HLA-B27 positive) had a confirmed diagnosis of AS (by the modified New York criteria). Median time from disease onset to radiologic confirmation was 8.0 years. Annual incidence of primary AS (n = 417) was 7.26, while estimated point prevalence rose from 0.036% in 1970 to 0.10% in 1980 and to 0.21% in 1990 with a period prevalence of 0.26%. AS was secondary to psoriasis or IBD in 117 patients (18.1%), with a diagnostic delay similar to that in primary AS. Annual incidence (14.1) and period prevalence in 1982-1993 (0.41%) were significantly higher in the town of Tromsø than in the surrounding rural region (5.21 and 0.22%, respectively). Mortality in patients with AS was low.
The incidence of AS was relatively stable in the northern part of Norway over a 34-year period. Incidence and prevalence are higher than reported in similar studies from Finland and Minnesota, possibly due to a higher population prevalence of HLA-B27.
确定在挪威最北部的两个县，经过一段较长时间强直性脊柱炎（AS）的发病率和患病率，当地人群中HLA - B27患病率较高。
我们对1960年至1993年间在挪威北部大学医院登记诊断为AS的所有患者进行了一项队列研究，该医院是为这些县服务的唯一风湿病科。我们记录了所有患者的人口统计学信息、疾病发病年份（临床疾病）和诊断年份（X线片确认）。AS患者临床疾病的发病日期用于计算发病率。年发病率以及点患病率/期间患病率以每10万成年人表示。原发性AS定义为不存在银屑病或炎症性肠病（IBD）的AS。
共有534例患者（男性占75.1%，临床诊断时平均年龄24.2岁，93.0% HLA - B27阳性）确诊为AS（根据改良纽约标准）。从疾病发作到放射学确认的中位时间为8.0年。原发性AS（n = 417）的年发病率为7.26，而估计的点患病率从1970年的0.036%上升到1980年的0.10%，并在1990年升至0.21%，期间患病率为0.26%。117例患者（18.1%）的AS继发于银屑病或IBD，诊断延迟与原发性AS相似。特罗姆瑟镇的年发病率（14.1）和1982 - 1993年的期间患病率（0.41%）显著高于周边农村地区（分别为5.21和0.22%）。AS患者的死亡率较低。
在34年期间，挪威北部AS的发病率相对稳定。发病率和患病率高于芬兰和明尼苏达州类似研究中的报告，可能是由于HLA - B27在人群中的患病率较高。
