Singh Gurmeet, Lawrence Abel, Agarwal Vikas, Misra Ramnath, Aggarwal Amita
Department of Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
J Clin Rheumatol. 2008 Oct;14(5):264-6. doi: 10.1097/RHU.0b013e31817b8789.
To study the difference in the clinical presentation of patients of ankylosing spondylitis (AS) with and without peripheral arthritis.
We performed a retrospective analysis of case records of 271 AS patients seen in the last 15 years at our center and diagnosed as AS according to modified New York criteria. We compared clinical features between patients with and without peripheral arthritis.
There were 253 (93%) men with a M:F ratio of 9:1, and 78 (28%) patients had Juvenile onset AS (JAS). Mean age at the disease onset was 22.4 +/- 9.3 years. Eighty-four patients had peripheral arthritis. Patients with peripheral arthritis had significantly higher prevalence of onset in childhood (36% vs. 25% P = 0.04), hip joint involvement (55% vs. 44%, P = 0.04), dactylitis (10% vs. 1%, P = 0.0006), enthesitis (28% vs. 7%, P = 0.0006), and uveitis (36 vs. 20%, P = 0.005) when compared with patients without peripheral arthritis.
Higher prevalence of juvenile onset and extra-articular manifestations in the form of uveitis, dactylitis, and enthesitis in patients with peripheral arthritis suggests that this subset of AS might have different factors involved in disease pathogenesis.
研究伴或不伴外周关节炎的强直性脊柱炎（AS）患者临床表现的差异。
我们对过去15年在本中心就诊且根据改良纽约标准诊断为AS的271例患者的病历进行了回顾性分析。我们比较了有外周关节炎和无外周关节炎患者的临床特征。
有253例（93%）男性，男女比例为9:1，78例（28%）患者为幼年起病型AS（JAS）。疾病发病的平均年龄为22.4±9.3岁。84例患者有外周关节炎。与无外周关节炎的患者相比，有外周关节炎的患者在儿童期发病的患病率显著更高（36%对25%，P = 0.04）、髋关节受累（55%对44%，P = 0.04）、指（趾）炎（10%对1%，P = 0.0006）、附着点炎（28%对7%，P = 0.0006）和葡萄膜炎（36%对20%，P = 0.005）。
外周关节炎患者幼年起病以及葡萄膜炎、指（趾）炎和附着点炎等关节外表现的患病率较高，提示这一亚组AS可能有不同的疾病发病机制相关因素。
