Ankylosing spondylitis (later referred to as AS) is often referred to as an undead cancer, meaning that it is very difficult to treat and patients have a poor quality of life. However, with systematic and regular treatment, many patients are able to manage their disease well and reduce their pain. In cases where the family is not well off, systematic treatment is difficult.
Diagnosis of ankylosing spondylitis: Based on the medical history, inflammatory spondylosis should be considered with the following manifestations.
1. insidious appearance of low back discomfort ;
2, age <40 years;
3, persistent for more than 3 months;
4, stiffness in the early morning;
5, Improvement in activity symptoms. With the above history and radiographs showing signs of sacroiliac arthritis, the diagnosis of spondylosis is confirmed; further exclusion of psoriasis, inflammatory bowel disease or Reiter’s syndrome arthritis can make the diagnosis of primary AS, rather than waiting until the spine is clearly ankylosed to make a definitive diagnosis.
The current commonly used clinical diagnostic criteria for AS are the New York diagnostic criteria proposed in 1965.
1. The lumbar spine is restricted in three directions: forward flexion, lateral bending, and backward elevation;
2, pain or history of pain in the lumbar spine or low back for more than 3 months;
3. Restricted expansion of the thorax, measured at the level of the 4th intercostal space, with expansion ≤ 2.5 cm.
According to the above clinical criteria and grading of sacroiliac arthritis x-ray changes.
1, confirm the diagnosis of AS as.
(1) Bilateral sacroiliac arthritis grade III or IV, with at least one of the above clinical criteria;
(2) Unilateral sacroiliac arthritis grade III or IV, or bilateral sacroiliac arthritis grade II, with clinical criteria item Ⅰ, or with clinical criteria item 2 and item 3.
2. Suspected AS is: bilateral sacroiliac arthritis grade III or IV, but those who do not have any of the clinical criteria. It is not known whether this patient has done the examination of B27. 70’s found that AS patients are closely related to human leukocyte antigen with B27 (HLA a B27, abbreviated as B27). the rate of B27 positivity in our general population is 5%-7%, but in AS patients reaches more than 90%.
It has been reported that among the first-degree relatives of 7 B27+ AS patients, 48.5% of the B27+ patients and 24.2% of the AS prevalence are significantly higher than the general population, indicating that AS has a tendency to gather in families.
Drugs used to treat AS can be divided into three categories.
1. Drugs that control disease activity and affect disease progression, such as sulfasalazine, methotrexate, and now the latest “biological agents” with significant efficacy (e.g., Ixaben, which was launched in November 2007). It is suitable for active AS, AS with peripheral arthritis and newly discovered AS.
2.Non-steroidal anti-inflammatory drugs Suitable for patients with severe pain and stiffness at night, and can be taken at bedtime.
3.Analgesics and myorelaxants such as analgesic new, prednisolone myosuprine, often used for those who are ineffective in long-term application of NSAIDs. Patients feel the economic pressure of using Yisai spectrum, you can choose other drugs according to the situation, it is best to often to the local regular hospital review, because the need for a long time to take drugs, will affect the liver and kidney function and other issues.