目的提高对强直性脊柱炎的临床认识。方法对220例强直性脊柱炎患者的临床资料进行回顾性分析。结果 220例强直性脊柱炎患者中,男女比例为4.5∶1;男性始发病年龄偏小,隐匿起病者192例(87.5%),伴四肢关节受累165例(68%),其中155例(65%)为下肢关节受累。220例AS患者经正规的SASP+MTX+反应停+非甾体类抗炎药并结合指导功能锻炼,其中165例症状明显改善,33例症状改善,20例症状无明显改变,2例症状加重,无症状改善的22例中有10例改单用益赛普50mg/周治疗,均症状明显改善,220例患者放射学改变评级均无改善,其中38例恶化。结论强直性脊柱炎多见于青年男性,其首发症状多为慢性腰痛,临床易误诊,骨盆正位片、骶髂关节炎及HLA-B27阳性有助于早期诊断和治疗,甲氨喋呤和柳氮磺吡啶、反应停是治疗AS的有效药物,但对中枢关节病变无明显效果,生物制剂对用于慢作用药效果欠佳患者的症状治疗有效,但对放射学改变无明显改善。 Objective To improve the clinical knowledge of ankylosing spondylitis. Methods The clinical data of 220 patients with ankylosing spondylitis were analyzed retrospectively. Results Among the 220 patients with ankylosing spondylitis, the ratio of male to female was 4.5:1. The incidence of male onset age was small, 192 cases (87.5%) were insidious onset, 165 cases (68%) had limb involvement, 155 (65%) affected lower extremity joints. 220 cases of AS patients with formal SASP + MTX + stop + NSAIDs combined with instructive functional exercise, of which 165 cases improved significantly, 33 cases improved symptoms, no significant change in 20 cases, 2 cases of aggravating symptoms, Among the 22 asymptomatic improvement cases, 10 cases were treated with only 50 mg / day of etanercept. The symptoms of both groups were significantly improved. The radiological changes of 220 patients were not improved. Among them, 38 patients deteriorated. Conclusions Ankylosing spondylitis is more common in young males. The first symptom is mostly chronic low back pain. Clinical misdiagnosis, pelvic anastomosis, sacroiliitis and HLA-B27 positive are helpful for early diagnosis and treatment. Methotrexate and Willow Sulfasalazine, the response to stop the treatment of AS is an effective drug, but no significant effect on the central joint disease, biological agents for the treatment of symptoms in patients with poor efficacy of effective treatment, but no significant improvement in radiological changes.