课件：僵直性脊椎炎的中西医观点.pptVIP

疾病活动：BASDAI ≥4(0-10)和专家确认（临床特征、血清急性期反应物，影像学特征中至少有一项阳性),疾病活动≥4周 Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) 病人自测 10cmVAS(visual analog scales)尺 回答6个问题。过去1周内你的水平： 疲劳 AS 脊柱(后背、颈部) 或臀部疼 除外上述关节，其他关节的疼痛或肿胀 触痛或痛压不适 醒来后的晨僵 晨僵持续时间 Bath Ankylosing Spondylitis Functional Index (BASFI) Visual analog scale (VAS) – 10 cm 对功能残疾程度的问题: 1. 不需帮助穿袜子 2. 从地上捡起钢笔 3. 不需帮助够到高架 4. 从无扶手的椅子上站起 5. 躺在地板上自己站起来 6. 不扶物品，站立10分钟 7. 不扶物品，爬楼梯12-15级。 8. 回头看 9. 进行剧烈活动 10. 从事全天活动 Bath Ankylosing Spondylitis Metrology Index (BASMI) 分数 0 1 2 1 耳墙距离 15cm 15~30cm 30cm 2 腰弯曲度 4cm 2~4cm 2cm 3 颈部旋转度 70° 20~70° 20° 4 腰侧弯 10cm 5~10cm 5cm 5 踝间距 100cm 70~100cm 70cm 说明：评分范围从0~10。0-轻度；1-中度；2-重度 Jenkinson TR, Mallorie PA, Whitelock H, Kennedy LG, Garrett SL, Calin A. Defining spinal mobility in ankylosing spondylitis: the Bath Ankylosing Spondylitis Metrology Index. J Rheumatol 1994; 21:1694–8. 生物制剂应用的经验 根据病情决定药物的用量，不同的剂量所达到的临床目的是不同的。 根据病情决定用药的方式 配合中药减少用药量和复发的频率 THANK YOU SUCCESS * * 可编辑 页眉 * 页眉 * Clinical Features of AS Sacroiliitis is the hallmark feature of AS1 and the earliest, most consistent findings are traceable to effects of sacroiliitis and enthesitis. Inflammation of the discovertebral, apophyseal, costovertebral, and costotransverse joints of the spine, and paravertebral ligamentous structures are frequently associated with AS. After many years, chronic inflammation can cause bony ankylosis.2 ? Chronic low back pain and stiffness, which typically worsens following a period of prolonged inactivity (eg, morning stiffness), are common presentations.1 Over time, lumbar spine mobility becomes restricted in all planes and posture becomes abnormal because of flattening of the lumbar spine and accentuated dorsal spine kyphosis. Radiographic findings in advanced disease include erosions, sclerosis of adjacent bones, pseudo-widening of the sacroiliac joint space, and fibrosis, calcification, interosseous bridging, and ossification of the sacroiliac joints. Extraskeletal manifestations are