Uppal S S, Pande I, Singh G, Kailash S, Kakker R, Kumar A, Mehra N K, Giri T K, Sekharan N G, Malaviya A N
Department of Medicine, All India Institute of Medical Sciences, New Delhi.
Br J Rheumatol. 1995 Feb;34(2):137-40. doi: 10.1093/rheumatology/34.2.137.
Unclassifiable seronegative spondyloarthropathy (SSA) syndrome is primarily considered to be an affliction of males. In this report from northern India, 25 HLA-B27 antigen positive females with this condition are described and compared with 39 HLA-B27-positive males with the same disease. All these patients presented with typical features of spondyloarthropathy such as predominantly lower limb synovitis, enthesopathy and inflammatory spinal pain. The onset was insidious in 56% of the females and in 64% of the males. The mean age of onset as also the mean duration of symptoms prior to diagnosis were significantly higher in females (26.2 vs 19.4 yr and 8 vs 2 yr, respectively). A mono- or oligo-arthritis was seen in 52% of the females and in 53% of the males, but the average number of joints involved was less in females (4.8 vs 7.7). Lower limb joints alone were involved in 56% of the females and 49% of the males, with the knees, ankles and hips being most commonly involved, often asymmetrically. The mean degree of symmetry was significantly lower in females (62 vs 76). Ninety-two per cent of females and 74% of males had inflammatory spinal pain. Radiographic sacroiliitis was demonstrable in 56% females and 74% males. It is concluded that 'unclassifiable' SSA syndrome is not infrequent in females but is diagnosed late. Fewer joints tend to be involved and there is greater tendency towards asymmetry in females.
无法分类的血清阴性脊柱关节病（SSA）综合征主要被认为是男性的一种疾病。在这份来自印度北部的报告中，描述了25例患有这种疾病的HLA - B27抗原阳性女性，并与39例患有相同疾病的HLA - B27阳性男性进行了比较。所有这些患者都表现出脊柱关节病的典型特征，如主要为下肢滑膜炎、附着点病和炎性脊柱疼痛。56%的女性和64%的男性起病隐匿。女性的平均发病年龄以及诊断前症状的平均持续时间显著更高（分别为26.2岁对19.4岁和8年对2年）。52%的女性和53%的男性出现单关节炎或寡关节炎，但女性受累关节的平均数量较少（4.8个对7.7个）。仅下肢关节受累的女性为56%，男性为49%，其中膝盖、脚踝和臀部最常受累，且通常不对称。女性的平均对称程度显著更低（62对76）。92%的女性和74%的男性有炎性脊柱疼痛。56%的女性和74%的男性可显示出影像学骶髂关节炎。结论是，“无法分类的”SSA综合征在女性中并不罕见，但诊断较晚。女性受累关节往往较少，且不对称倾向更大。
