英文-强直性脊柱炎教学讲义.pptVIP

ANKYLOSING SPONDYLITIS Ankylosing Spondylitis Introduction Etiology Clinical feature Diagnosis Treatment Introduction Ankylosing Spondylitis(AS) is a chronic seronegative in-flammatory disease that affects the axial skeleton, especia-lly the sacroiliac joints,hip joints,and spine. Extraskeletal involvement is found in the aorta, lung, and uvea. The characteristics of this disease is the sacroilitis, which spread upward slowly to the spine, finally cause complete rigidity or (and) deformity of the spine. The disease usually has its onset during early adulthood and males are affected more frequently than females with the male/female ratio of 2-7:1. Etiology Heredity factor Approximately 90% of people with AS express the ? HLA-B27 ?genotype and 1-2% of individuals with the HLA-B27 genotype contract the disease, meaning there is a strong genetic association. Infection The disease is commonly conmitant with prostatitis, ulcerative colitis and pelvic infection, so investigators have postulated that infection is?one?of the?etiological?agent for the disease. 3. Autoimmunity Auto-antibodies specific for AS have not been identified. Anti-neutrophil cytoplasmic antibodies?(ANCAs) are associated with AS, but do not correlate with disease severity. Clinical feature Diagnosis Peak onset : between 20 and 30 years of age. The initial symptoms are insidious and advance gradually, including pain in the buttocks, heels, and low back, sometimes companied by systemic features, such as fatigue, anorexia, mild fever and weight loss. At the outset, the pain is intermittent, then it gradually become durative when the disease progess. Eventually, some patients devolop loss of motion and subsequent loss of kyphosis in the cervical and lumbar spine。 Clinical feature Diagnosis Spondylitis，starts in the sacroiliac joint, gradually migrates cephalad to lumbar, thoracic, and cervical spine. Pain and loss of motion of the low back are caused