Wilson病合并强直性脊柱炎5例分析
摘要
目的分析Wilson病(WD)合并强直性脊柱炎(AS)患者的临床特征及治疗的相关性。方法选择安徽中医药大学神经病学研究所附属医院神经内科自2012年1月至2018年3月收治的5例WD合并AS患者,回顾性分析患者的性别、发病年龄、病史、影像学检查等临床资料。结果 5例患者均为男性,9～26岁发病,2例因脑部症状/或合并肝硬化而先诊断为WD,2例因腰背部疼痛、关节活动受限而先诊断为AS,1例因上述症状同时出现诊断为WD和AS。入院时与出院后3个月的AS病情活动程度进行比较,差异有统计学意义(P=0.048)。结论 WD合并AS患者发病年龄轻,伴有多器官损害,及时诊断、治疗对患者预后有重要意义。
引文
[1]杨任民.肝豆状核变性[M].北京:人民卫生出版社,2015:98.
[2]STRAND V,RAO S A,SHILLINGTON A C,et al.Prevalence of axial spondyloarthritis in United States rheumatology practices:Assessment of Spondylo Arthritis international Society criteria versus rheumatology expert clinical diagnosis[J].Arthritis Care Res(Hoboken),2013,65(8):1299-1306.
[3]LIAN F,ZHOU J,WEI C,et al.Anti-TNF-αagents and methotrexate in spondyloarthritis related uveitis in a Chinese population[J].Clin Rheumatol,2015,34(11):1913-1920.
[4]李坤鹏,黄烽.强直性脊柱炎:一种被忽视的全身性疾病[J].中华内科杂志,2015,54(11):13-15.
[5]杨任民.肝豆状核变性[M].北京:人民卫生出版社,2015:181-182.
[6]VAN D L S,VALKENBURG H A,CATS A.Evaluation of diagnostic criteria for ankylosing spondylitis[J].Arthritis Rheum,1984,27(4):361-368.
[7]杨任民.肝豆状核变性[M].北京:人民卫生出版社,2015:70.
[8]SIEPER J,RUDWALEIT M,BARALIAKOS X,et al.The Assessment of Spondylo Arthritis international Society(ASAS)handbook:a guide to assess spondyloarthritis[J].Ann Rheum Dis,2009,68(Suppl 2):ii1-ii44.
[9]CANELAS H M,CARVALHO N,SCAFF M,et al.Osteoarthropathy of hepatolenticular degeneration[J].Acta Neurol Scand,2010,57(6):481-487.
[10]叶嗣源.孤立性早发骨关节炎型肝豆状核变性的基因型和临床病程-家系两患病同胞[D].济南:山东大学,2017.
[11]张海云,程楠,韩咏竹.Wilson病的流行病学研究进展[J].安徽医学,2014,35(3):400-402.
[12]蔡安季,戴勇,李武县,等.强直性脊柱炎患者外周血单个核细胞中急性时相反应蛋白的差异表达研究[J].第三军医大学学报,2013,35(19):2084-2087.
[13]吴君霞,杨茜,薛明月,等.血清铜生化对肝豆状核变性的诊断意义[J].检验医学,2013,28(1):21-24.
[14]WENDLING D,VANLEMMENS C,PRATI C,et al.Two cases of ankylosing spondylitis and Wilson’s disease in the same patient.Only a fortuitous association?[J].Joint Bone Spine,2012,79(4):418-419.
[15]方明娟,杨任民,吴君霞,等.肝豆状核变性患者血常规检验结果分析[J].安徽医学,2015,36(5):516-518.
[16]HAROON N,INMAN R D,LEARCH T J,et al.The impact of tumor necrosis factor alpha inhibitors on radiographic progression in ankylosing spondylitis[J].Arthritis Rheum,2013,65(10):2645-2654.
[2]STRAND V,RAO S A,SHILLINGTON A C,et al.Prevalence of axial spondyloarthritis in United States rheumatology practices:Assessment of Spondylo Arthritis international Society criteria versus rheumatology expert clinical diagnosis[J].Arthritis Care Res(Hoboken),2013,65(8):1299-1306.
[3]LIAN F,ZHOU J,WEI C,et al.Anti-TNF-αagents and methotrexate in spondyloarthritis related uveitis in a Chinese population[J].Clin Rheumatol,2015,34(11):1913-1920.
[4]李坤鹏,黄烽.强直性脊柱炎:一种被忽视的全身性疾病[J].中华内科杂志,2015,54(11):13-15.
[5]杨任民.肝豆状核变性[M].北京:人民卫生出版社,2015:181-182.
[6]VAN D L S,VALKENBURG H A,CATS A.Evaluation of diagnostic criteria for ankylosing spondylitis[J].Arthritis Rheum,1984,27(4):361-368.
[7]杨任民.肝豆状核变性[M].北京:人民卫生出版社,2015:70.
[8]SIEPER J,RUDWALEIT M,BARALIAKOS X,et al.The Assessment of Spondylo Arthritis international Society(ASAS)handbook:a guide to assess spondyloarthritis[J].Ann Rheum Dis,2009,68(Suppl 2):ii1-ii44.
[9]CANELAS H M,CARVALHO N,SCAFF M,et al.Osteoarthropathy of hepatolenticular degeneration[J].Acta Neurol Scand,2010,57(6):481-487.
[10]叶嗣源.孤立性早发骨关节炎型肝豆状核变性的基因型和临床病程-家系两患病同胞[D].济南:山东大学,2017.
[11]张海云,程楠,韩咏竹.Wilson病的流行病学研究进展[J].安徽医学,2014,35(3):400-402.
[12]蔡安季,戴勇,李武县,等.强直性脊柱炎患者外周血单个核细胞中急性时相反应蛋白的差异表达研究[J].第三军医大学学报,2013,35(19):2084-2087.
[13]吴君霞,杨茜,薛明月,等.血清铜生化对肝豆状核变性的诊断意义[J].检验医学,2013,28(1):21-24.
[14]WENDLING D,VANLEMMENS C,PRATI C,et al.Two cases of ankylosing spondylitis and Wilson’s disease in the same patient.Only a fortuitous association?[J].Joint Bone Spine,2012,79(4):418-419.
[15]方明娟,杨任民,吴君霞,等.肝豆状核变性患者血常规检验结果分析[J].安徽医学,2015,36(5):516-518.
[16]HAROON N,INMAN R D,LEARCH T J,et al.The impact of tumor necrosis factor alpha inhibitors on radiographic progression in ankylosing spondylitis[J].Arthritis Rheum,2013,65(10):2645-2654.