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目的 :了解强直性脊柱炎 (AS)严重髋关节病变的临床特点及相关因素。方法 :对 6 5例严重髋关节病变已行髋关节置换术的AS患者 (A组 )和 130例无髋关节病变的AS患者 (B组 )进行对比分析。结果 :A组发病年龄及病程均短于B组 (P <0 0 5 ) ;以外周关节病起病A组明显高于B组 (P <0 0 1) ;A组全身症状和外周关节炎比B组重 (P <0 0 1) ;ESR ,CRP ,IgG ,IgM及r-球蛋白水平A组均高于B组 (P <0 0 5 ) ;X线检查骶髂关节及脊柱病变两组无明显差异 ;早期用柳氮磺胺吡啶 (SASP)治疗的人数A组少于B组 (P <0 0 5 ) ,早期用激素治疗的人数A组多于B组 (P <0 0 5 )。结论 :发病年龄早、病情进展快 ,以外周关节起病伴全身症状重以及外周关节炎者易发生髋关节严重破坏 ,炎症或免疫反应、早期应用激素可能与髋关节破坏有关。早期用SASP治疗 ,尽量避免用激素 ,可防止或减缓髋关节破坏或其进展
Objective: To understand the clinical features and related factors of severe hip arthroplasty in ankylosing spondylitis (AS). Methods: Sixty-five AS patients (group A) with hip arthroplasty and 130 patients without AS (group B) undergoing hip arthroplasty were compared and analyzed. Results: The age and course of disease in group A were shorter than that in group B (P <0.05). The incidence of peripheral arthropathy in group A was significantly higher than that in group B (P <0.01). The symptoms and peripheral arthritis in group A (P <0.01); The levels of ESR, CRP, IgG, IgM and r-globulin in group A were higher than those in group B (P <0.05); X-ray examination of sacroiliac joint and spine There was no significant difference between the two groups (P <0.05). The number of early treatment with SASP was less in group A than in group B (P <0.05) . CONCLUSION: Early onset of disease, rapid progression of the disease, severe peripheral disfunction, inflammation or immune response are likely to occur in patients with peripheral joint disease and peripheral arthritis. Early application of hormones may be related to hip joint destruction. Early treatment with SASP, try to avoid using hormones, can prevent or slow the destruction of the hip or its progress