- 期刊
僵直性脊椎炎－早期認知，早期治療
Ankylosing Spondylitis-Early Diagnosis, Early Treatment
摘要
僵直性脊椎炎(ankylosing spondylitis)是一個常見的慢性發炎性關節炎，它的主要特色是中軸關節炎(axial joint inflammation)、週邊關節炎(peripheral arthritis)、及肌腱韌帶附著點病變(enthosopathy)。其好發於年輕男性，且與B27型人類白血球組織抗原(HLA-B27)有強烈的相關性。持續地慢性發炎會導致脊椎關節產生粘連骨贅(syndesmophyte)，進而關節粘黏(ankylosing)，於是造成其功能的喪失(functional disability)。運動(exercise)和非類固醇性消炎止痛藥(NSAIDs)是過去長久以來僵直性脊椎炎的標準治療方法。使用Sulfasalazine可以改善病人週邊關節炎的症狀，局部類固醇注射可以使用於不易控制的附著點發炎或週邊關節炎。然而過去這幾年來新的生物製劑(biologic agents)陸續地被發展出來，特別是抗腫瘤壞死因子製劑(anti-tumor necrosis factor α)的應用，其能夠快速地、顯著且持續地改善病人的症狀，包括脊椎炎和週邊關節炎等，同時也能夠減緩骨關節病變的發生，這是治療上一項重要的進展。
並列摘要
Ankylosing spondylitis is a common chronic inflammatory rheumatic disease, characterized by axial joint inflammation, peripheral arthritis, and enthesopathy. It primarily affect young male, and has strong linkage with HLA-B27. Persistent inflammation could lead to the bony growth or syndesmophyte, ankylosing of the adjacent vertebral body, and loss of functional ability. Exercise and nonsteroidal anti-inflammatory drugs (NSAIDs) are the standard therapy for the patients with ankylosing spondylitis. Sulfasalazine is helpful in the patients with peripheral arthritis. Local steroids injections are also widely used in refractory enthesopathy and peripheral arthritis. The most important progress in the treatment of ankylosing spondylitis is the newly development of anti-tumor necrosis factor-α (TNF-α) drugs. Patient's can achieve rapid, significant and sustained improvement with these biologic agents.