骨盆正位像评价强直性脊柱炎髋关节病变临床意义研究

发布时间：2018-03-26 06:51

本文选题：强直性脊柱炎　切入点：髋关节　出处：《中国实用内科杂志》2017年06期

【摘要】：目的总结强直性脊柱炎(ankylosing spondylitis,AS)患者骨盆正位像中髋关节病变的特点,以及骨盆正位像在评价AS患者髋关节病变中的意义。方法对2010-01-01—2015-12-31期间中国医科大学附属第一医院风湿免疫科门诊就诊或住院的79例AS患者进行骨盆正位像检查,详细分析髋关节病变的特征,比较髋关节有无异常患者的临床特点,并借助统计学方法对数据和研究结果进行分析。结果 48例(60.8%)患者骨盆正位像提示髋关节出现异常改变,其中最具特征的表现为继发于肌腱端炎的慢性改变和髋关节间隙变窄。与髋关节正常组患者比较,异常组患者疾病病程更长[(9.1±6.2)年对(5.5±6.3)年,P=0.02],血清C-反应蛋白(C-reactive protein,CRP)水平更高[(34.8±34.4)mg/L对(19.1±16.5)mg/L,P=0.02];异常组患者中40例患者伴有臀部疼痛,而正常组中仅有13例患者主述臀部疼痛,两组比较差异有统计学意义(40/48对13/31,P0.01)。另外,64例患者出现典型的骶髂关节的改变,包括局限性或弥漫的骶骨和髂骨硬化、侵蚀;伴或不伴关节间隙的改变、甚至间隙消失。结论骨盆正位像作为最基本的影像学手段,反映了AS患者髋关节病变的特征,对理解AS的髋关节病变具有重要意义。建议将骨盆正位像作为筛查髋关节疾病的常规检查方法。
[Abstract]:Objective to summarize the features of hip joint lesions in orthograph of pelvis in patients with ankylosing spondylitis (ASA) of ankylosing spondylitis. Methods from 2010-01-01-2015-12-31, 79 patients with as were examined by pelvic orthography in the Department of Rheumatology and Immunology, the first affiliated Hospital of China Medical University, during the period 2010-01-01-2015-12-31. The characteristics of hip joint lesions were analyzed in detail, the clinical features of patients with abnormal hip joint were compared, and the data and results were analyzed by means of statistical method. The most characteristic manifestations were chronic changes in tendinitis and narrowing of the hip joint space, compared with those in the normal hip group. The course of disease in abnormal group was longer [9.1 卤6.2] years vs 5.5 卤6.3 years, and the level of serum C-reactive protein was higher [34.8 卤34.4)mg/L vs 19.1 卤16.5 mg / L / L], 40 patients in abnormal group had pain in buttocks, while only 13 patients in normal group had pain in their buttocks. There was a statistically significant difference between the two groups (40 / 48 vs 13 / 31 P0.01). In addition, 64 patients had typical sacroiliac joint changes, including localized or diffuse sacral and iliac sclerosis, erosion, with or without joint space changes. Conclusion pelvic orthography as the most basic imaging method reflects the characteristics of hip joint lesions in patients with as. It is of great significance to understand the hip disease of as. It is suggested that pelvic orthographies should be used as a routine method for the screening of hip diseases.
【作者单位】：中国医科大学附属第一医院风湿免疫科;
【基金】：国家自然科学基金(81271324)
【分类号】：R593.23

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