临床荟萃

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脊柱关节炎规范化诊治进展

  

  1. 河北医科大学第二医院 风湿免疫科,河北 石家庄 050000
  • 出版日期:2019-04-20 发布日期:2019-05-16
  • 通讯作者: 郭惠芳,Email:guohfch@ 126.com
  • 作者简介:郭惠芳,河北医科大学第二医院免疫风湿科副主任,医学博士,主任医师,教授,硕士生导师。现任河北省医学会风湿病分会常务委员,河北省医师学会风湿病分会常务委员,河北省免疫学会理事,河北省免疫学会风湿病专业委员会副主任委员、河北省药学会风湿病专业委员会副主任委员。20多年来,一直致力于风湿性疾病的临床及基础研究,在国内外期刊发表学术论文40余篇,主研省厅级课题多项,获得河北省科技进步三等奖2项。

Progress in standardized diagnosis and treatment of  spondyloarthritis

  1. Department of Rheumatology and Immunology, the Second Hospital of
    Hebei Medical University, Shijiazhuang 050000, China
  • Online:2019-04-20 Published:2019-05-16
  • Contact: Corresponding author: Guo Huifang, Email: guohfch@ 126.com

摘要: 脊柱关节炎(SpA)是临床常见的风湿病,是诱发腰背部疼痛的常见病因,中青年男性患者高发,临床症状不典型时,容易漏诊和误诊。近年来,SpA的诊治指南已多次更新。基于“达标治疗”策略的实施,影像学在SpA患者的诊断、治疗和随访中的作用日益凸显。非甾体抗炎药在SpA治疗中仍然保持着基础治疗地位,生物制剂在SpA中的应用时机、适用范围、转化原则清晰明确,而国际关节炎评估工作组-欧洲抗风湿病联盟(ASASEULAR)均反对全身使用糖皮质激素治疗活动性强直性脊柱炎,非甾体抗炎药、生物制剂、以及糖皮质激素的应用选择原则十分明确。

关键词: 脊柱关节炎, 诊断, 规范化管理, 指南及共识意见

Abstract: Spondyloarthritis (SpA) is a common rheumatic disease, which is the main cause of low back pain, young and middleaged men have high incidence. When the clinical symptoms and signs are not typical, it is easy to misdiagnose. In recent years, the guidelines for the diagnosis and treatment of SpA have been updated many times. Based on the “treat to target” treatment strategy, imaging examination plays an increasingly prominent role in the diagnosis, treatment and followup of patients with SpA. NonSteroidal Antiinflammatory drugs (NSAIDs) still belong to the basic treatment in SpA. The application opportunity and its scope and transformation principle of biological agents in SpA are clear and definite, while adopting systemic glucocorticoid therapy for active SpA in Assessment of Spondylo  Arthritis International Society(ASAS)the European League Against Rheumatism(EULAR) have been opposed. Above all, the application principles of biological agents, NSAIDs and glucocorticoids are very clear.

Key words: spondyloarthritis, diagnosis;standardized management, guidelines and consensus opinions