强直性脊柱炎(轴性脊柱炎)的视图来源

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您请求的操作仅限于组中的用户:==流行病学/病因学==[[文件:ankylose process.jpg|右|无边框]]]AS影响0.1%至1.4%的人口。李建平，李建平，李建平，李建平。强直性脊柱炎的研究进展。风湿病学(互联网)。2014 Apr[引自2020 Sep 26];53(4), 650 - 657。可从https://academic.oup.com/rheumatology/doi.org/10.1093/rheumatology/ket387 获得。影像学诊断的中轴性脊柱炎的男女比例为2:1，非影像学诊断的中轴性脊柱炎的男女比例为1:1。症状一般发生在20-40岁之间。不到5%的病例在45岁以上出现症状。 AS在欧洲(平均每10,000人中有23.8人)和亚洲(平均每10,000人中有16.7人)比在拉丁美洲(平均每10,000人中有10.2人)更为普遍。 AS的病因尚不完全清楚。尽管遗传背景和环境因素之间的复杂相互作用已经建立了强有力的联系。王丽娟，王丽娟，王丽娟，王丽娟，王丽娟，等[https://www.frontiersin.org/articles/10.3389/fimmu.2018.02668/full]强直性脊柱炎早期临床与基础研究进展。免疫学前沿。 2018:2668. Studies have shown factors such as genetic background gene called ( HLA-B27), microbial infection, endocrinal abnormalities and immune reaction related to the occurrence of AS. In addition, a direct relationship between AS and the major histocompatibility human leukocyte antigen (HLA)-B27 has also been determined.Alvarez I, López de Castro JA. HLA-B27 and immunogenetics of spondyloarthropathies. Curr Opin Rheumatol. 2000;12(4):248-253 Alvarez I, de Castro JA. [https://journals.lww.com/co-rheumatology/Fulltext/2000/07000/HLA_B27_and_immunogenetics_of.3.aspx HLA-B27 and immunogenetics of spondyloarthropathies]. Current opinion in rheumatology. 2000 Jul 1;12(4):248-53. The exact role of this antigen is unknown but is believed to act as a receptor for an inciting antigen leading to AS. HLA-B27 occurs in 90-95% of patients with ankylosing spondylitis, compared to a 6 to 9% incidence in the normal population.  Environmental or bacterial factors can also be a trigger. Braggins S. Back care: a clinical approach. Churchill Livingstone; 2000. Initially, there is an infiltration of the subchondral bone by granulation tissue which causes small lesions, ultimately leading to joint erosion (the adjacent cartilage is distorted which produces a very irregular surface). These lesions in the annulus eventually undergo ossification, leading to a fusion effect of the spinal segments and the similarity in appearance to bamboo. In the spine, this occurs at the junction of the vertebrae and the annular fibres of the intervertebral disc. When synovium is the affected tissue, there is an infiltration by macrophages and lymphocytes. This is followed by replacement of the cartilage or fibrous tissue by a scar-like fibroblast invasion which rapidly ossifies. The inflammatory response in the bone adjacent to the involved fibrocartilage, ligament or periosteum is frequently quite severe. The spine can resemble an infectious discitis when the spine is initially involved, which can be an additional source of confusion for the treating therapist. 

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