强直性脊拄炎(AS)曾被认为是中心型类风湿关节炎,由于人类组织相关抗原(HLA)的研究进展及 AS 的许多临床表现的研究,证明该病应为一独立的疾病。本文对40例 AS 患者的 HLA 及部分患者骨骼外脏器受损情况进行了研究,证明本病多为青年起病,有明显遗传倾向,患者中 HLA-B27阳性者占90%。7例 HLA-B27阳性患者同一亲代共18例的调查中,10例可确诊为 AS,发病率达56%。随机选择22例行二维超声心动图及多普勒检查,发现1例主动脉无冠瓣环及瓣叶轻度增厚,3例左室内径轻度增大,2例有心包积液。18例行尿十二烷基磺酸钠二聚丙烯胺电泳(SDS-PAGE)测定,14例异常,占77%,以肾小管受损为主。40例患者的胸相中,1例有双上肺纤维化,伴斑点状阴影。14例行肺功能测定患者中,10例异常,占71%,以弥散功能障碍为主。 Ankylosing spondylitis (AS) was once considered a central form of rheumatoid arthritis and the disease should prove to be an independent disease because of the progress made in the study of human tissue-associated antigens (HLA) and many clinical manifestations of AS. In this paper, 40 cases of AS patients with HLA and some patients with external damage to the skeleton were studied to prove that the disease mostly young onset, a clear genetic predisposition, patients with HLA-B27-positive accounted for 90%. Of the 7 HLA-B27-positive patients with the same parental 18 cases, 10 were diagnosed as AS with a morbidity of 56%. Twenty-two patients were randomly selected to undergo two-dimensional echocardiography and Doppler examination. One case had aortic non-crowned annulus and mildly enlarged valve leaflets, three cases had mild left ventricular diameter enlargement and two cases had pericardial effusion. 18 cases of urinary sodium dodecyl sulfonate dipolyacrylamide electrophoresis (SDS-PAGE) determination, 14 cases were abnormal, accounting for 77% of renal tubular damage. Forty patients had a single upper pulmonary fibrosis with a speckled shadow in the thorax. Of the 14 patients who underwent pulmonary function tests, 10 were abnormal, accounting for 71% of them, mainly diffuse dysfunction.