强直性脊柱炎傅志均.pptVIP

强直性脊柱炎  Ankylosing Spondylitis，AS 骨二区 傅志均 Ankylosing Spondylitis，AS Ankylosing spondylitis (AS), is a form of arthritis (关节炎）that primarily affects the spine, although other joints can become involved. It causes inflammation (炎症) of the spinal joints that can lead to severe, chronic pain and discomfort. In the most advanced cases (but not in all cases), this inflammation can lead to new bone formation on the spine, causing the spine to fuse in a fixed, immobile position, sometimes creating a forward-stooped posture. This forward curvature of the spine is called kyphosis（驼背）. Description（概况） Low back pain, with prominent morning stiffness; improves with use and warmth; sometimes nocturnal (夜间发生的) Often insidious (潜伏) in onset in young adults Loss of chest expansion (胸廓扩张度) as disease progresses Associated with peripheral arthritis, enthesitis （起止点炎）, and extra-articular manifestations, such as iritis (虹膜炎) Most frequently found in young men under 40 Clinical finding—Symptom： Non-traumatic back pain and stiffness (僵硬), which improves with activity Decreased range of motion in lumbar spine Thoraco-cervical kyphosis (late) One-third of patients will have acute, unilateral uveitis.（葡萄膜炎） Other Complications Pseudoarthrosis (假关节), cervical spine fracture, C1-C2 subluxation, cauda equina syndrome Peripheral joint ankylosis Restrictive lung disease, upper lobe fibrosis Aortic root dilation (20%) murmur (2%) Clinical finding—sings： Bilateral(双侧) sacroiliac(骶髂部) tenderness A dramatic loss of flexibility（柔韧性、灵活性） in the lumbar spine is an early sign (Schober test) Loss of chest expansion, 2.5cm (normal 5cm), from diffuse costovertebral involvement Weight loss (also a symptom) Clinical finding—sings cont： Recurrent, acute iritis (虹膜炎) presents as a painful red eye Neurologic signs:resulting from compression radiculitis (脊神经根炎) or sciatica（坐骨神经痛） Anemia Aortic insuffi