Clinical Characteristics Of Ankylosing Spondylitis Complicated With Uveitis

Objectives:To explore the clinical features of ankylosing spondylitis(AS) patients with uveitis and how the uveitis effect the disease severity, prognosis and treatment.Subject:AS patients with or without uveitisMethods:A retrospective analysis of the clinical feature was made among301patients with AS, who visited outpatient or inpatient department of rheumatism in the Clinical Medical College of Yangzhou University from2009.6to2012.6. AS patients with uveitis or not were defined as uveitis group and non uveitis group. All the patients consistent with the1984modified New York criteria of AS.All patients’gender, age, course of disease, global score, morning stiffness, duration of the morning stiffness, peripheral joint involvement, Bath Ankylosis Spondylitis Disease Activity Index (BASDAI), Bath Ankylosis Spondylitis Functional Index (BASFI), treatment and the result of CRP, ESR, CD25, HLA-B27, hip MRI were collected.All statistical analysis made in SPSS17.0and Excel2007software. The study examined the statistical significance of measurement data by the independent samples t test and chi square test was used for examine the statistical significance of count data.Results:There were301AS patients, including218males and83females. The ratio of male to female was about2.6:1. There were36cases haveing or ever had uveitis (11.96%).In the36patients who with uveitis,18(50%) patients with uveitis occurs after onset of AS at least one year age. There were14(38.89%) patients with uveitis occurs within one year after the the pain. There were3(8.33%) patients developed uveitis at the beginning of the disease. There were28patients with recurrent uveitis. In the patients with recurrent uveitis there were only tow cases with monocular attack, while the others were bilateral alternative involvement.There were6cases with visual decreased obviously. There were28(77.78%) patients in the uveitis group with peripheral arthritis, more than in the non uveitis group。There are no statistical significance in Sex ratio, age of onset, morning stiffness, duration of morning stiffness, the global score of discomfort, C-reactive protein, ESR, BASDAI score, positive rate, HLA-B27and hip involvement rate between uveitis group and non uveitis group. Yet in the uveitis group the course of disease was longer than non uveitis group (P=0.006). In uveitis group the patients with CD25elevated in56.67%, more than the non uveitis group. Physical function index (BASFI) score was significantly higher than that of non uveitis group in uveitis group, and the difference had statistical significance.The biological agents used in41.67%patients with uveitis, while in the non uveitis group the use of biological agents was24.53%, the difference was statistically significant (P=0.029).Conclusions:(1) Majority of AS complicated with uveitis were recurrent attacks, can be the first sympyom, or occurred in the AS after the onset, or even can appeared several years before the occurrence of disease.(2) The incidence of uveitis in AS patients was increases with the duration, regardless of the gender, age of onset and HLA-B27.(3) Patients with uveitis had no significant effect on disease activity, yet the physical functioning impaired seriously than the non uveitis group.(4) AS complicated with uveitis may be associated with increased CD25.(5) Patients with uveitis are more likely to have peripheral joints involvement.(6) As the high rate of recurrence and can cause vision loss, and even blindness, the patients with uveitis should first biologic therapy.