作者：刘新疆 房清敏 秦东京 翟峰 韩兆东 李振勇 邢学玲 张兰
【摘要】 目的 对66例强直性脊柱炎早期临床表现、骶髂关节的CT表现和实验室特点进行分析。方法 66例患者,男60例、女6例,年龄17～57岁,平均25.7岁。全部病例行骶髂关节的多层螺旋CT轴位平扫,并记录其HLAB27及血沉(ESR)检查结果。结果 髋部疼痛者占63%,腰痛者占40%。多层螺旋CT征象,以骶髂关节变毛糙、模糊、受侵蚀出现率最高,68.1%；其他如关节硬化50%，关节间隙变窄36.3%，关节融合9.1%。实验室检查结果HLAB27阳性、ESR变快分别为100%、92%。结论 强直性脊柱炎患者早期腰痛、外周关节炎、“4”字试验阳性、骶髂关节压痛和腰椎压痛为常见症状和体征。骶髂关节的多层螺旋CT检查,常见骶髂关节变毛糙、模糊、受侵蚀征象，实验室检查HLAB27呈阳性是早期重要的诊断依据。
【关键词】 强直性脊柱炎; 临床分析；骶髂关节;多层螺旋CT ；HLAB27表达
【Abstract】 Objective To analyzed the clinical features,laboratory examination and sacroiliac joint CT signs of ankylosing spondylitis.Methods Of all 66 cases,60 were male,6 were female,the age ranges from 17 to 57 years with average of 25.7.All patients accepted MSCT axial scan of sacoiliac joint,their prominent clinical features and laboratory examination were registered.Results The hip department ache accounts for 63%, the lumbago accounts for 40%. The MSCT sign, changes by the sacroiliac joint coarse, fuzzy, is corroded the frequency of occurrence to be highest, 68.1%. Other like arthrosclerosis was 50%; The joint gap stricts was 36.3%,joint fusion was 9.1%, ESR examining result , HLAB27 change a laboratory into 100% , 92% respectively.Conclusion Cycle arthritis, “4” characters test masculine gender , sacroiliac joint tenderness and lumbar vertebra tenderness are to frequently see symptom and the body go on a punitive expedition to outside scorching patient of sacroiliac joint early phase lumbago. Multilayer sacroiliac joint helix CT is examined, the common sacroiliac joint is changed into the diagnosis basis coarse ,fuzzy,accepting to corrode the sign , the laboratory examining that HLAB27 is positive is that early phase is important.
【Key words 】 ankylosing spondylitis,clinical analysis,sacroiliac joint,MSCT,expression of HLAB27
强直性脊柱炎(ankylosing spondylitis,AS)是一原因不明的以中轴关节慢性炎症为主的全身性疾病。随着病情发展,几乎全部累及骶髂关节。骶髂关节(sacroiliac joint,SIJ)受累是强直性脊柱炎主要和特征性改变,并被认为是强直性脊柱炎最早期改变；多层螺旋CT检查能真实而准确地反映其发病部位及不同阶段的进展情况；组织相容性抗原（HLAB27）阳性预告值很高，阴性预告值较低，HLAB27实验结果具有高度敏感性和特异性。本文总结了66例经我院临床诊断为强直性脊柱炎患者的早期临床表现、骶髂关节的多层螺旋CT表现和HLAB27表达的结果,现分析如下。
1 资料与方法
