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[脊柱关节炎患者的识别。新的分类标准]

[The recognition of patients with spondyloarthritis. New classification criteria].

作者信息

Landewé Robert B M, van der Heijde Désirée M F M

机构信息

Academisch Medisch Centrum, afd. Klinische Immunologie & Reumatologie, Amsterdam.

出版信息

Ned Tijdschr Geneeskd. 2011;155(30-31):A3680.

Abstract

Spondyloarthritis (SpA) is an umbrella term for a group of rheumatic diseases characterised by inflammation of the sacroiliac (SI) joints and vertebral column; today, differentiation is made between axial SpA and peripheral SpA. Ankylosing spondylitis (Bechterew's disease) is the most typical form of axial SpA whereby sacroiliitis can be found on X-rays of the SI joints. Axial SpA can, however, also be present without radiographic evidence of sacroiliitis. A range of SpA-related symptoms can also manifest themselves outside the musculoskeletal system, for example, uveitis, psoriasis and inflammatory intestinal diseases. Tumour necrosis factor (TNF)-α inhibitors play an important role in the treatment of SpA. New classification criteria have recently been established in which MRI of the SI joints and the presence of the HLA-B27 tissue antigen are key. Axial and peripheral SpA should be recognized early in order to be able to successfully treat these conditions.

摘要

脊柱关节炎(SpA)是一组风湿性疾病的统称,其特征为骶髂(SI)关节和脊柱的炎症;如今,轴向SpA和外周SpA有所区分。强直性脊柱炎(别赫捷列夫病)是轴向SpA最典型的形式,在SI关节的X线片上可发现骶髂关节炎。然而,轴向SpA也可能在没有骶髂关节炎影像学证据的情况下出现。一系列与SpA相关的症状也可能在肌肉骨骼系统之外表现出来,例如葡萄膜炎、银屑病和炎症性肠病。肿瘤坏死因子(TNF)-α抑制剂在SpA的治疗中发挥着重要作用。最近制定了新的分类标准,其中SI关节的MRI和HLA-B27组织抗原的存在是关键。应尽早识别轴向和外周SpA,以便能够成功治疗这些病症。

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