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目的 对 2 2例强直性脊柱炎的临床、实验室特点和骶髂关节的CT表现进行分析。方法 2 2例患者 ,男 2 0例、女 2例 ,年龄 14～ 70岁 ,平均 2 7.9岁。全部病例行骶髂关节的CT轴位平扫 ,并记录其显著的几项临床、实验室检查特点。结果 临床特点中 ,骶髂关节的疼痛、腰痛、弯腰受限居于前三位 ,出现百分率依次为 6 3.6 %、40 .9%、31.8%。实验室检查结果 ,HLA -B2 7阳性、血沉(ESR)变快、C反应蛋白 (CRP)增高、类风湿因子 (RF)阳性出现百分率各为 10 0 %、90 .9%、31.8%、2 7.2 %。CT征象 ,以骶髂关节变毛糙、模糊、受侵蚀出现率最高 ,6 8.1%。其他如关节硬化 ,5 0 % ;关节间隙变窄 36 .3% ;关节融合 9.1%。结论 强直性脊柱炎患者最常出现的临床表现为髋部疼痛 ;化验检查HLA -B2 7呈阳性 ,ESR加快 ,CRP增高是重要的诊断依据 ;骶髂关节的CT检查 ,常见骶髂关节变毛糙、模糊、受侵蚀征象。
Objective To analyze the clinical and laboratory features of 22 cases of ankylosing spondylitis and the CT findings of sacroiliac joint. Method 2 2 patients, 20 males and 2 females, aged 14 to 70 years, mean 2 7.9 years old. CT scan of sacroiliac joint in all cases was performed and several significant clinical and laboratory features were recorded. Results Among the clinical features, the sacroiliac joint pain, lumbago and flexion limited to the top three, with the percentages of 6 3.6%, 40.9% and 31.8%, respectively. The results of laboratory tests showed that HLA-B2 7 positive, ESR and C-reactive protein (CRP) were increased, and the positive percentage of RF was 100%, 90.9% and 31.8%, respectively 7.2%. CT signs of sacroiliac joints become rough, fuzzy, the highest incidence of erosion, 6 8.1%. Others such as sclerosis, 50%; joint space narrowed 36.3%; joint fusion 9.1%. Conclusion The most common clinical manifestations of ankylosing spondylitis are hip pain. HLA-B2 7 is positive in laboratory tests, ESR is accelerated and CRP is an important diagnostic basis. CT examination of sacroiliac joint, common sacroiliac joint becomes rough Blurred, corroded signs.