摘要目的 探讨脊柱关节炎(SpA)患者的临床特征及合并症的性别差异.方法 纳入2013年1月至2015年7月在中山大学附属第三医院门诊或住院部就诊的SpA患者346例,其中男280例,女66例.比较两组患者在发病年龄、病程、家族史、HLA-B27阳性率、临床症状、血红细胞沉降率、C反应蛋白(CRP)、Bath AS疾病活动指数(BASDAI)、AS病情活动度评分(ASDAS)、Bath AS功能指数(BASFI)及共患病的差异.结果 男性发病年龄较女性早(22±7比27±9,P＜0.001),晨僵的比例较高(74.3％),CRP及ASDAS-CRP指数更高(P＜0.010,P=0.014),两组患者在临床症状、家族史、HLA-B27、BASDAI、BASFI、治疗药物等方面差异无统计学意义.男性SpA患者共患有HBV感染(26.2％)较女性(8.3％)更多,并更容易出现骨质疏松(30.5％比14.3％,P＜0.01).通过Logistic分析得出,低体质量(OR=0.94,P＜0.001),高ASDAS-CRP(OR=1.58,P=0.006)及男性(OR=8.02,P=0.004)患骨质疏松的概率显著提高.结论 男性SpA患者发病年龄较女性早,更易出现晨僵,ASDAS-CRP活动指数升高.两者在疾病临床表现、功能状态、治疗药物等方面未表现出明显的性别差异.男性SpA患者共患有HBV感染较女性更多,且更容易患有骨质疏松.临床医生应提高对SpA患者共患病情况的重视程度.

abstractsObjectives The aim of the study was to determine whether there was gender difference in clinical manifestations and comorbidities in the patients with Spondyloarthritis (SPA) in China.Methods 346 patients fulfilling ASAS criteria for SpA were recruited from the Third Affiliated Hospital of Sun Yat-sen University,including 280 males and 66 females.A comparison was conducted in terms of age at onset,disease course,family history,HLA-B27 positivity,clinical manifestations,erythrocyte sedimentation rate (ESR),and C-reactive protein (CRP),the bath ankylosing spondylitis disease activity index (BASDAI) and AS disease activity score (ASDAS),and comorbidities between male and female patients.Results Compared with female patients,male patients were younger at disease onset (22±7 vs 27±9,P＜0.001),had higher rates of morning stiffness (74.3％),and higher scores of CRP and ASDAS-CRP (P＜0.010,P=0.014).However,no significant gender difference was observed in other clinical parameters like clinical manifestations,family history,HLA-B27 positivity,BASDAI,and BASFI and treatment.Male SpA patients had a higher prevalence of Hepatitis B virus (HBV) infection (26.2％) than that of female patients (8.3％),and a higher prevalence of osteoporosis (30.5％ vs 14.3％,P＜0.01),especially with a lower lumbar T score.Logistic regression analysis reviewed that limited weight (OR=0.94,P＜0.001),high ASDAS-CRP (OR=1.58,P=0.006) and male (OR=8.02,P=0.004) are more inclined to have osteoporosis.Conclusion Compared with female patients,male patients were younger at disease onset and higher scores of CRP and ASDAS-CRP.No significant gender difference was observed in clinical manifestations,family history,HLA-B27 positivity,BASDAI,and BASFI and treatment.Male SpA patients had a higher prevalence of HBV infection and osteoporosis than female patients.Comorbidities should be paid more attention in the patients with SpA.