Clinical and Radiographic Features of Adult-onset Ankylosing Spondylitis in Korean Patients: Comparisons between Males and Females
Clinical and Radiographic Features of Adult-onset Ankylosing Spondylitis in Korean Patients: Comparisons between Males and Females
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DOI：
10.3346/jkms.2010.25.4.532
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发表时间：
2010-04-01
影响因子：
4.5
通讯作者：
Kim, Hyun Ah
中科院分区：
文献类型：
--
作者：
Jung, Young-Ok;Kim, Inje;Kim, Hyun Ah
本研究的目的是调查韩国成人强直性脊柱炎患者的临床和影像学特征以及性别差异。在韩国13家三级转诊医院的风湿病诊所进行了多中心横断面研究。根据改良纽约标准，所有患者均确诊为强直性脊柱炎。评估了临床、实验室和放射学特征，并使用Bath强直性脊柱炎疾病活动指数评估了疾病活动度。招募了505名患者。男女比例为6.1：1。平均发病年龄为25.4 ± 8.9岁，平均病程为9.6 ± 6.8年。男性在明显更早的年龄表现出症状。HLA-B27在男性中更常见。髋关节在男性中更常见，膝关节在女性中更常见。当使用耳屏-体壁距离和改良的斯科贝尔试验测量脊柱活动度时，女性的结果明显更好。调整混杂因素后，影像学脊柱改变，包括竹棘和韧带赘生物，在男性中更常见。总之，我们观察到韩国成人强直性脊柱炎患者的影像学脊柱受累以及其他临床表现存在显著的性别差异。这些发现可能会影响诊断的时机和治疗的选择。
The objective of this study was to investigate clinical and radiographic features and gender differences in Korean patients with adult-onset ankylosing spondylitis. Multicenter cross-sectional studies were conducted in the rheumatology clinics of 13 Korean tertiary referral hospitals. All patients had a confirmed diagnosis of ankylosing spondylitis according to the modified New York criteria. Clinical, laboratory, and radiographic features were evaluated and disease activities were assessed using the Bath ankylosing spondylitis disease activity index. Five hundred and five patients were recruited. The male to female ratio was 6.1:1. Average age at symptom onset was 25.4 +/- 8.9 yr and average disease duration was 9.6 +/- 6.8 yr. Males manifested symptoms at a significantly earlier age. HLA-B27 was more frequently positive in males. Hips were more commonly affected in males, and knees in females. When spinal mobility was measured using tragus-to-wall distance and the modified Schober's test, females had significantly better results. Radiographic spinal changes, including bamboo spine and syndesmophytes, were more common in males after adjustment of confounding factors. In conclusion, we observed significant gender differences in radiographic spinal involvement as well as other clinical manifestations among Korea patients with adult-onset ankylosing spondylitis. These findings may influence the timing of the diagnosis and the choice of treatment.