Beslek Asli, Onen Fatos, Birlik Merih, Akarsu Mesut, Akar Servet, Sari Ismail, Gurler Oguz, Akpinar Hale, Manisali Metin, Akkoc Nurullah
Department of Internal Medicine, Dokuz Eylul Universtiy School of Medicine, Izmir, Turkey.
Rheumatol Int. 2009 Jun;29(8):955-7. doi: 10.1007/s00296-008-0811-5. Epub 2008 Dec 10.
Rheumatic manifestations are the most common extraintestinal findings of inflammatory bowel disease (IBD), although there are wide variations among different studies. The only previous Turkish study reported a rather high prevalence of spondyloarthritis (SpA) in patients with IBD. We aimed to determine the frequency of SpA and ankylosing spondylitis (AS) in patients with IBD attending a gastroenterology clinic from a referral centre. The study was conducted in 122 patients with established diagnosis of IBD [28 with Crohn's disease (CD) and 94 with ulcerative colitis (UC)]. A detailed medical history was obtained and a complete physical examination was performed in all the patients. Standard pelvic X-rays for examination of the sacroiliac joints were performed only when clinically indicated. The X-rays were read blindly by an experienced rheumatologist and reported according to the established grading system. The modified New York criteria were used to classify AS, and the European Spondyloarthropathy Study Group criteria for SpA. The prevalence of AS and SpA in patients with IBD was 8.2 and 28.7%, respectively. SpA was found to be significantly more common in the patients with CD compared to patients with UC, but the frequency of AS was not different between these two groups. There was no correlation between localisation or extent of the intestinal inflammation and presence of AS and SpA. A higher frequency of women was observed in patients diagnosed as SpA. Almost half of the patients with SpA (45.7%) had not been diagnosed before the study, although they had a history of IBP and/or peripheral arthritis. This study suggests that the prevalences of SpA and AS in Turkish patients with IBD are similar to those in many other populations. There may be a significant female predominance of SpA among patients with IBD.
风湿性表现是炎症性肠病（IBD）最常见的肠外表现，尽管不同研究之间存在很大差异。之前唯一一项土耳其的研究报告称，IBD患者中脊柱关节炎（SpA）的患病率相当高。我们旨在确定来自转诊中心的胃肠病诊所的IBD患者中SpA和强直性脊柱炎（AS）的发生率。该研究对122例确诊为IBD的患者进行[28例克罗恩病（CD）患者和94例溃疡性结肠炎（UC）患者]。所有患者均详细询问了病史并进行了全面体格检查。仅在临床有指征时才进行用于检查骶髂关节的标准骨盆X光检查。X光片由一位经验丰富的风湿病学家进行盲法阅读，并根据既定的分级系统进行报告。采用改良纽约标准对AS进行分类，采用欧洲脊柱关节病研究组标准对SpA进行分类。IBD患者中AS和SpA的患病率分别为8.2%和28.7%。与UC患者相比，CD患者中SpA明显更常见，但两组之间AS的发生率没有差异。肠道炎症的部位或范围与AS和SpA的存在之间没有相关性。诊断为SpA的患者中女性比例更高。几乎一半的SpA患者（45.7%）在研究之前未被诊断出来，尽管他们有炎性背痛（IBP）和/或外周关节炎病史。这项研究表明，土耳其IBD患者中SpA和AS的患病率与许多其他人群相似。IBD患者中SpA可能存在明显的女性优势。
