强直性脊柱炎、赖特综合征和银屑病关节炎患者的临床比较。
Clinical comparison of patients with ankylosing spondylitis, Reiter's syndrome and psoriatic arthritis.
作者信息
Deesomchok U, Tumrasvin T
机构信息
Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
出版信息
J Med Assoc Thai. 1993 Feb;76(2):61-70.
Between 1976 and 1989, 160 cases of seronegative spondyloarthropathy (SNSA) were admitted to the Department of Medicine at Chulalongkorn Hospital. The prevalence of idiopathic ankylosing spondylitis (IdAS) was 52 cases (32.5%), Reiter's syndrome (RS) 68 cases (42.5%), psoriatic arthritis (PsA) 28 cases (17.5%), reactive arthritis eight cases (5.0%) and Behcet's disease four cases (2.5%). Clinical comparison of the patients with IdAS, RS and PsA showed a male predominance in IdAS (90.2%), RS (97.1%) and PsA (71.4%). There was a significant difference (p < 0.01) between IdAS and PsA, and RS and PsA. The initial articular manifestation usually occurred in the younger age group (IdAS, 22.15; RS, 22.91; and PsA, 30.86 years); however, there was a significant difference (p < 0.05) between IdAS and PsA, and RS and PsA. Initial peripheral arthritis was found in IdAS (51.9%), RS (91.2%) and PsA (92.6%); there was a significant difference (p < 0.001) between IdAS and RS, and IdAS and PsA. The symptom of back pain was found in IdAS (78.8%), RS (38.2%) and PsA (21.4%); there was a significant difference (p < 0.001) between IdAS and RS, and IdAS and PsA. During physical examination, peripheral arthritis was evident in the IdAS (42.2%), RS (88.2%) and PsA (92.2%) patients; likewise sacroiliitis was found in the IdAS (100%) RS (54.4%), and PsA (57.2%) patients. Evidence of ankylosing spondylitis was found in the IdAS (100%), RS (22.1%) and PsA (46.4%) patients. These findings show a significant difference (p < 0.001) between patients with IdAS and RS, IdAS and PsA. Other associated symptoms were similar, particularly evidence of enthesopathy (tendonitis, heel pain, plantar fasciitis), the polyarticular pattern was more common than the mono-articular pattern. Hip joint was significantly (p < 0.05) more commonly involved in patients with IdAS than in those with RS and PsA. Associated symptoms, particularly genital lesion or skin lesion, are specific symptoms for RS and PsA, respectively.
1976年至1989年间，朱拉隆功医院内科收治了160例血清阴性脊柱关节病（SNSA）患者。其中，特发性强直性脊柱炎（IdAS）52例（32.5%），赖特综合征（RS）68例（42.5%），银屑病关节炎（PsA）28例（17.5%），反应性关节炎8例（5.0%），白塞病4例（2.5%）。对IdAS、RS和PsA患者的临床比较显示，IdAS患者中男性占比90.2%，RS患者中男性占比97.1%，PsA患者中男性占比71.4%。IdAS与PsA之间、RS与PsA之间存在显著差异（p<0.01）。初始关节表现通常出现在较年轻的年龄组（IdAS为22.15岁，RS为22.91岁，PsA为30.86岁）；然而，IdAS与PsA之间、RS与PsA之间存在显著差异（p<0.05）。IdAS患者中初始外周关节炎的发生率为51.9%，RS患者中为91.2%，PsA患者中为92.6%；IdAS与RS之间、IdAS与PsA之间存在显著差异（p<0.001）。IdAS患者中背痛症状的发生率为78.8%，RS患者中为38.2%，PsA患者中为21.4%；IdAS与RS之间、IdAS与PsA之间存在显著差异（p<0.001）。体格检查时，IdAS患者中外周关节炎的发生率为42.2%，RS患者中为88.2%，PsA患者中为92.2%；同样，IdAS患者中骶髂关节炎的发生率为100%，RS患者中为54.4%，PsA患者中为57.2%。IdAS患者中强直性脊柱炎的证据发生率为100%，RS患者中为22.1%，PsA患者中为46.4%。这些结果表明，IdAS与RS患者之间、IdAS与PsA患者之间存在显著差异（p<0.001）。其他相关症状相似，尤其是附着点病（肌腱炎、足跟痛、足底筋膜炎）的证据，多关节模式比单关节模式更常见。IdAS患者中髋关节受累的比例显著高于RS和PsA患者（p<0.05）。相关症状，特别是生殖器病变或皮肤病变，分别是RS和PsA的特异性症状。
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