Glasnović Marija, Bosnjak Ivica, Sram Miroslav, Vranjes Zeljko, Vcev Aleksandar, Dobrosević Blazenka, Petricević Jasminka Sincić, Horvatić Elizabeta, Orkić Zelimir, Tadzić Refmir, Soldo Anamarija, Sisljagić Dina, Dinjar Kristijan
"J. J. Strossmayer" University, Osijek University Hospital Center, Clinic for Internal Medicine, Osijek, Croatia.
Coll Antropol. 2011 Jun;35(2):397-402.
The aim of this study was to present our experiences in diagnosing spondyloarthritides (SpA), and to list the most common clinical features of HLA-B27 positive patients. The study included 65 HLA-B27 positive patients with confirmed diagnosis of ankylosing spondylitis (AS) and psoriatic arthritis (PsA) who were analyzed between 2009 and 2010 in Clinic of Internal Medicine in Osijek. The diagnosis of seronegative spondyloarthritides was based on the ASAS (Assessment in AS Working Group) classification criteria for axial and then supplemented with ASAS criteria for peripheral SpA and was confirmed by radiological techniques. For diagnosing the ankylosing spondylitis (AS), there have been applied the modified New York criteria. Radiological criteria for definite sacroiliitis according to the modified New York criteria is bilateral sacroiliitis, grade 2-4 (> or = 2) or unilateral sacroiliitis, grade 3-4. For diagnosing the psoriatic arthritis (PsA), there were used CASPAR diagnostic criteria. Other features of SpA are defined within the existing classification criteria. HLA-B27 antigen was determined by direct immune-fluorescence technique using flow cytometer. The average age of patients was 50.34 years, of whom 27 female (41.53%), 38 male (58.46%). Duration of illness was 15.79 years on average. With 75.38% of patients, there had been determined the diagnosis of AS; 24.62% of patients had the diagnosis of PsA. The most common clinical characteristics that patients had were: inflammatory back pain (pain Inflammation along the lumbosacral spine), peripheral arthritis, intermittent pain in the gluteus, sacroiliitis, enthesitis, uveitis, dactilitis.
本研究的目的是介绍我们在诊断脊柱关节炎（SpA）方面的经验，并列出HLA - B27阳性患者最常见的临床特征。该研究纳入了65例确诊为强直性脊柱炎（AS）和银屑病关节炎（PsA）的HLA - B27阳性患者，于2009年至2010年在奥西耶克内科诊所进行分析。血清阴性脊柱关节炎的诊断基于ASAS（强直性脊柱炎工作组评估）轴向分类标准，然后补充外周SpA的ASAS标准，并通过放射学技术确诊。对于强直性脊柱炎（AS）的诊断，采用了改良的纽约标准。根据改良纽约标准，明确骶髂关节炎的放射学标准为双侧骶髂关节炎，2 - 4级（≥2级）或单侧骶髂关节炎，3 - 4级。对于银屑病关节炎（PsA）的诊断，使用了CASPAR诊断标准。SpA的其他特征在现有分类标准中定义。HLA - B27抗原通过流式细胞仪直接免疫荧光技术测定。患者的平均年龄为50.34岁，其中女性27例（41.53%），男性38例（58.46%）。病程平均为15.79年。75.38%的患者被诊断为AS；24.62%的患者被诊断为PsA。患者最常见的临床特征为：炎性背痛（腰骶部脊柱的炎性疼痛）、外周关节炎、臀肌间歇性疼痛、骶髂关节炎、附着点炎、葡萄膜炎、指（趾）炎。
