强直性脊柱炎延迟诊断:可能原因和对预后的影响

被引：11

作者：

曹冬雪

郑艳

符向辉

杨丰钒

朱平

机构：

[1] 第四军医大学西京医院临床免疫科全军风湿免疫病专科研究所

来源：

现代生物医学进展 | 2015年 / 15卷 / 12期

关键词：

强直性脊柱炎; 延迟诊断; 影响因素; 预后;

D O I：

10.13241/j.cnki.pmb.2015.12.014

中图分类号：

R593.23 [强直性脊柱炎];

学科分类号：

100201 [内科学];

摘要：

目的:调查强直性脊柱炎(AS)延迟诊断的情况,并分析其原因以及对疾病预后的影响。方法:收集2012年8月至2014年10月西京医院风湿免疫科收治的AS患者376例,均符合1984年修订的纽约分类标准,采用当面询问并填写调查问卷的形式收集患者的临床资料。从人口参数和临床特征等方面调查AS患者延迟诊断的原因,并分析不同延迟诊断时间对疾病预后的影响。结果:376例AS患者的平均延迟诊断时间为(72.52±70.80)月。幼年发病AS(JOAS)患者的延迟诊断时间(90.48±77.17月)明显长于成年发病患者(AOAS)(63.45±58.85月),差异有统计学意义(P=0.033)。具有关节外表现的AS患者的延迟诊断时间(93.04±67.25月)显著长于无关节外表现患者(62.09±66.16月),差异有统计学意义(P=0.036)。误诊组延迟诊断时间(92.09±74.95月)明显长于非误诊组(46.09±55.41月),差异有统计学意义(P=0.001)。与早期诊断组相比,晚期诊断组患者的AS疾病活动度评分(ASDAS)≥2的患者比例、Bath AS活动指数(BASDI)、Bath AS功能指数(BASFI)、Bath AS测量指数(BASMI)以及骶髂关节放射学分级均显著增高(P<0.05)。结论:临床医生应重视幼年发病和具有关节外表现的AS患者,减少误诊,这将有助于缩短AS患者延迟诊断的时间并改善其预后。

引用

收藏

页码：2257 / 2261

页数：5

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