\u810a\u690e\u95a2\u7bc0\u708e\u306f\u4ed9\u8178\u95a2\u7bc0\u3084\u810a\u690e\u306a\u3069\u306e\u4f53\u8ef8\u95a2\u7bc0\u306b\u708e\u75c7\u3092\u6765\u305f\u3057\u3001\u305d\u306e\u4ed6\u306b\u8171\u3084\u976d\u5e2f\u306e\u4ed8\u7740\u90e8\u708e\uff08\u30a2\u30ad\u30ec\u30b9\u8171\u3084\u80a9\u306a\u3069\uff09\u3001\u672b\u68a2\u6027\u95a2\u7bc0\u708e\u3001\u6307\u8dbe\u708e\u3001\u3076\u3069\u3046\u819c\u708e\u3001\u4e7e\u766c\u3001\u708e\u75c7\u6027\u8178\u75be\u60a3\u306a\u3069\u3092\u5408\u4f75\u3057\u307e\u3059\u3002\u810a\u690e\u3084\u95a2\u7bc0\u306e\u75bc\u75db\u3084\u976d\u5e2f\u4ed8\u7740\u90e8\u306e\u708e\u75c7\u306b\u3088\u308b\u904b\u52d5\u5236\u9650\u3001\u304a\u3088\u3073\u305d\u306e\u5408\u4f75\u75c7\u30fb\u7d9a\u767a\u75c7\u306b\u3088\u308a\u60a3\u8005\u69d8\u306equality of life\uff08QOL\uff09\u3092\u5927\u304d\u304f\u640d\u306a\u3046\u75be\u60a3\u3067\u3042\u308a\u307e\u3059\u3002<\/p>\n
\u810a\u690e\u95a2\u7bc0\u708e\u306e\u75be\u60a3\u6982\u5ff5\u306f\u3001\u75c7\u72b6\u3068\u3057\u3066\u4f53\u8ef8\u6027\u53ca\u3073\u672b\u68a2\u6027\u306b\u5206\u985e\u3055\u308c\u307e\u3059\u3002\u4f53\u8ef8\u6027\u306b\u306f\u5f37\u76f4\u6027\u810a\u690e\u708e\uff08AS\uff09\u3001\u672b\u68a2\u6027\u306b\u306f\u4e7e\u766c\u6027\u95a2\u7bc0\u708e\uff08PsA\uff09\u304c\u4e2d\u5fc3\u3068\u306a\u3063\u3066\u304a\u308a\u3001\u305d\u306e\u307b\u304b\u306bSAPHO\u75c7\u5019\u7fa4\uff085%\uff09\u3001\u53cd\u5fdc\u6027\u95a2\u7bc0\u708e\uff084%\uff09\u3001\u708e\u75c7\u6027\u8178\u75be\u60a3\u95a2\u9023\u810a\u690e\u95a2\u7bc0\u708e(2%)\u3001\u3076\u3069\u3046\u819c\u708e\u95a2\u9023\u810a\u690e\u95a2\u7bc0\u708e\u3001\u672a\u5206\u985e\u810a\u690e\u95a2\u7bc0\u708e\u306a\u3069\u304c\u542b\u307e\u308c\u307e\u3059\u3002\u305d\u308c\u305e\u308c\u304c\u30aa\u30fc\u30d0\u30fc\u30e9\u30c3\u30d7\u3057\u3066\u3044\u308b\u3068\u3044\u3046\u306e\u304c\u3053\u308c\u3089\u75be\u60a3\u306e\u7279\u5fb4\u3067\u3042\u308a\u3001HLA-B27<\/em>\u3068\u306e\u95a2\u9023\u6027\u304c\u793a\u3055\u308c\u305f\u75be\u60a3\u3067\u3042\u308a\u307e\u3059\u3002<\/p>\n \uff0aHLA\u3068\u306f<\/p>\n HLA\uff08Human Leukocyte Antigen\uff1d\u30d2\u30c8\u767d\u8840\u7403\u6297\u539f\uff09\u306f1954\u5e74\u3001\u767d\u8840\u7403\u306e\u8840\u6db2\u578b\u3068\u3057\u3066\u767a\u898b\u3055\u308c\u307e\u3057\u305f\u3002HLA\u306f\u767d\u8840\u7403\u3060\u3051\u306b\u3042\u308b\u306e\u3067\u306f\u306a\u304f\u3001\u307b\u307c\u3059\u3079\u3066\u306e\u7d30\u80de\u3068\u4f53\u6db2\u306b\u5206\u5e03\u3057\u3066\u3044\u3066\u3001\u7d44\u7e54\u9069\u5408\u6027\u6297\u539f(\u514d\u75ab\u306b\u95a2\u308f\u308b\u91cd\u8981\u306a\u5206\u5b50)\u3068\u3057\u3066\u50cd\u3044\u3066\u3044\u308b\u3053\u3068\u304c\u660e\u3089\u304b\u306b\u306a\u308a\u307e\u3057\u305f\u3002<\/p>\n \u5f37\u76f4\u6027\u810a\u690e\u708e\uff08AS\uff09\u306f\u4ed9\u8178\u95a2\u7bc0\u708e\u304b\u3089\u767a\u75c7\u3059\u308b\u4f53\u8ef8\u6027\u306e\u95a2\u7bc0\u708e\u3067\u3059\u3002\u95a2\u7bc0\u306e\u7834\u58ca\u3088\u308a\u810a\u690e\u306e\u5f37\u76f4\u304c\u4e3b\u306a\u75c7\u72b6\u3067\u3059\u3002\u81e8\u5e8a\u7684\u7279\u5fb4\u3067\u3042\u308b\u8170\u80cc\u90e8\u75db\u306f\u3042\u308a\u3075\u308c\u305f\u75c7\u72b6\u3067\u3042\u308a\u3001\u75be\u60a3\u30de\u30fc\u30ab\u30fc\u3082\u306a\u304f\u3001X\u7dda\u5909\u5316\u3082\u7de9\u5f90\u3067\u3042\u308b\u3053\u3068\u306a\u3069\u304b\u3089\u3001AS\u306e\u8a3a\u65ad\u3001\u7279\u306b\u65e9\u671f\u8a3a\u65ad\u306f\u5fc5\u305a\u3057\u3082\u5bb9\u6613\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u3002<\/p>\n \u65e5\u672c\u4eba\u306e\u4e00\u822c\u4eba\u53e3\u3067\u306e\u4fdd\u6709\u7387\u304c0.2%\u3067\u3042\u308bHLA-B27\u3092\u6301\u3064\u983b\u5ea6\u304c\u9ad8\u304f\u3001\u8af8\u5916\u56fd\u306b\u6bd4\u3079\u3066\u60a3\u8005\u6570\u304c\u5c11\u306a\u3044\u3053\u3068\u3082\u3042\u3063\u3066\u3001\u305d\u306e\u8a3a\u65ad\u30fb\u6cbb\u7642\u6cd5\u304c\u5341\u5206\u306b\u306f\u666e\u53ca\u3057\u3066\u3044\u307e\u305b\u3093\u3002\u5b9f\u969b\u3001\u78ba\u5b9a\u8a3a\u65ad\u306b\u81f3\u308b\u307e\u3067\u306b\u6570\u5e74\u306e\u6b73\u6708\u3092\u8981\u3057\u3066\u3044\u308b\u30b1\u30fc\u30b9\u3082\u5c11\u306a\u304f\u306a\u304f\u3001\u305d\u306e\u8a3a\u65ad\u30fb\u6cbb\u7642\u6cd5\u304c\u5e83\u304f\u77e5\u3089\u308c\u305f\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u3068\u306f\u5bfe\u7167\u7684\u3067\u3042\u308a\u307e\u3059\u3002<\/p>\n \u75c7\u72b6<\/strong><\/p>\n \u7279\u5fb4\u7684\u306a\u75c7\u72b6\u3068\u3057\u3066\u3001\uff11\uff09\u810a\u690e\u30fb\u4ed9\u8178\u95a2\u7bc0\u708e\u306b\u3088\u308b\u8170\u80cc\u90e8\u75db\u3001\uff12\uff09\u4e0b\u80a2\u306b\u512a\u4f4d\u306a\u5c11\u95a2\u7bc0\u708e\u3001\uff13\uff09\u4ed8\u7740\u90e8\u708e\u304c\u6319\u3052\u3089\u308c\u307e\u3059\u3002\u8170\u80cc\u90e8\u75db\u306f\u708e\u75c7\u6027\u80cc\u90e8\u75db\uff08inflammatory back pain, IBP\uff09\u304c\u7279\u5fb4\u3068\u3055\u308c\u3001\u5f37\u76f4\u6027\u810a\u690e\u708e\u3067\u306f\u307b\u307c100%\u306e\u60a3\u8005\u3067\u3001\u4e7e\u766c\u6027\u95a2\u7bc0\u708e\u3067\u306f40%\uff5e78%\u306e\u60a3\u8005\u3067\u307f\u3089\u308c\u307e\u3059\u300240\u6b73\u4ee5\u4e0b\u3067\u3001\u904b\u52d5\u3067\u8efd\u5feb\u3057\u5b89\u9759\u3084\u540c\u3058\u59ff\u52e2\u3067\u60aa\u5316\u3059\u308b\u7279\u306b\u660e\u3051\u65b9\u306b\u5f37\u304f\u306a\u308b\u8170\u80cc\u90e8\u75db\u304c\u7279\u5fb4\u3067\u3059\u3002\u3053\u306e\u3088\u3046\u306aIBP\u306f\u5168\u3066\u306e\u8170\u75db\u306e15%\u7a0b\u5ea6\u306b\u307f\u3089\u308c\u308b\u3068\u8a00\u308f\u308c\u3001\u7269\u7406\u7684\u306a\u539f\u56e0\u306b\u3088\u308b\u8170\u75db\u306b\u6bd4\u3079\u3066NSAIDs\uff08\u30ed\u30ad\u30bd\u30cb\u30f3\u306a\u3069\u306e\u6297\u708e\u75c7\u5264\uff09\u306e\u6709\u52b9\u6027\u304c\u9ad8\u3044\u3068\u3044\u3046\u7279\u5fb4\u3082\u3042\u308a\u307e\u3059\u3002<\/p>\n \u4ed8\u7740\u90e8\u708e\uff08enthesitis\uff09\u3068\u306f\u3001\u7b4b\u8089\u304c\u8171\u3001\u976d\u5e2f\u3068\u306a\u308a\u9aa8\u306b\u4ed8\u304f\u90e8\u5206\u3067\u3042\u308b\u4ed8\u7740\u90e8\u306b\u8d77\u3053\u308b\u708e\u75c7\u3067\u3001\u672c\u75be\u60a3\u306e\u7279\u5fb4\u7684\u75c7\u5019\u3068\u8a00\u3048\u307e\u3059\u3002\u30a2\u30ad\u30ec\u30b9\u8171\u3084\u8db3\u5e95\u8171\u819c\u306e\u4ed8\u7740\u90e8\u306b\u3057\u3070\u3057\u3070\u898b\u3089\u308c\u307e\u3059\u3002<\/p>\n \u4e0a\u8a18\u306e\u4ed6\u306b\u7279\u5fb4\u7684\u306a\u75c7\u72b6\u3068\u3057\u3066\u3001\u3044\u308f\u3086\u308b\u6307\uff08\u8dbe\uff09\u708e\uff08dactylitis\uff09\u304c\u307f\u3089\u308c\u308b\u3053\u3068\u3082\u3042\u308a\u307e\u3059\u3002\u3053\u308c\u306f\u3001\u30bd\u30fc\u30bb\u30fc\u30b8\u69d8\u306e\u624b\u6307\u307e\u305f\u306f\u8db3\u8dbe\u306e\u816b\u8139\u3067\u3059\u3002<\/p>\n \u3055\u3089\u306b\u5f37\u76f4\u6027\u810a\u690e\u708e\u60a3\u8005\u3067\u306f\u95a2\u7bc0\u5916\u75c7\u72b6\u3001\u5408\u4f75\u75c7\u304c\u3088\u304f\u898b\u3089\u308c\u3001\u3076\u3069\u3046\u819c\u708e\u30fb\u8178\u708e\u30fb\u9aa8\u7c97\u9b06\u75c7\u30fb\u76ae\u819a\u75c7\u72b6\u306a\u3069\u304c\u307f\u3089\u308c\u307e\u3059\u3002<\/p>\n \u691c\u67fb<\/strong><\/p>\n \u753b\u50cf\u691c\u67fb\u3067\u306f\u624b\u8db3\u3001\u810a\u690e\u3001\u9aa8\u76e4\u306e\u30a8\u30c3\u30af\u30b9\u7dda\u3092\u65bd\u884c\u3057\u3001\u7279\u5fb4\u7684\u306a\u6240\u898b\uff08\u9aa8\u3073\u3089\u3093\u3001\u976d\u5e2f\u9aa8\u68d8\u3001\u7af9\u72b6\u810a\u690e\u306a\u3069\uff09\u3092\u8abf\u3079\u307e\u3059\u3002\u75c5\u6c17\u306e\u521d\u671f\u3067\u306f\u30a8\u30c3\u30af\u30b9\u7dda\u3067\u306f\u7570\u5e38\u304c\u307f\u3089\u308c\u306a\u3044\u3053\u3068\u3082\u591a\u3044\u305f\u3081\u3001MRI\u691c\u67fb\u3092\u884c\u3044\u307e\u3059\u30022009\u5e74\u306bASAS\uff08Assessment of SpondyloArthritis international Society\uff09\u306b\u3088\u308a\u4f53\u8ef8\u6027\u810a\u690e\u95a2\u7bc0\u708e\u306e\u5206\u985e\u57fa\u6e96\u304c\u30012011\u5e74\u306b\u672b\u68a2\u6027\u810a\u690e\u95a2\u7bc0\u708e\u306e\u5206\u985e\u57fa\u6e96\u304c\u4f5c\u6210\u3055\u308c\u307e\u3057\u305f\u3002\u3053\u306e\u5206\u985e\u57fa\u6e96\u3092\u7528\u3044\u308b\u3053\u3068\u306b\u3088\u3063\u3066\u30ec\u30f3\u30c8\u30b2\u30f3\u6240\u898b\u306e\u898b\u3089\u308c\u306a\u3044\u65e9\u671f\u306e\u72b6\u614b\u3067\u810a\u690e\u95a2\u7bc0\u708e\u3068\u5206\u985e\u3057\u6297\u4f53\u88fd\u5264\u3092\u542b\u3081\u305f\u85ac\u5264\u3092\u7528\u3044\u3066\u6cbb\u7642\u3059\u308b\u3053\u3068\u304c\u53ef\u80fd\u3068\u306a\u308a\u307e\u3057\u305f\u3002\u3057\u304b\u3057\u3001\u3053\u308c\u306f\u3042\u304f\u307e\u3067\u3082\u5206\u985e\u57fa\u6e96\u3067\u3042\u308b\u305f\u3081\u3001\u6700\u7d42\u7684\u306b\u306f\u8a73\u7d30\u306a\u75c5\u6b74\u3001\u5bb6\u65cf\u6b74\u306e\u8074\u53d6\u3084\u7406\u5b66\u6240\u898b\u306a\u3069\u304b\u3089\u78ba\u5b9a\u8a3a\u65ad\u3092\u4e0b\u3059\u3053\u3068\u304c\u809d\u8981\u3067\u3042\u308a\u307e\u3059\u3002\u5206\u985e\u57fa\u6e96\u306b\u306f\u9451\u5225\u30fb\u9664\u5916\u8a3a\u65ad\u304c\u306a\u3044\u305f\u3081\u3001\u5206\u985e\u57fa\u6e96\u306e\u30c1\u30a7\u30c3\u30af\u30ea\u30b9\u30c8\u306b\u305d\u306e\u307e\u307e\u5f53\u3066\u306f\u3081\u3066\u8a3a\u65ad\u3092\u3059\u308c\u3070\u3001\u8aa4\u8a3a\u3084\u904e\u5270\u8a3a\u65ad\u306b\u7e4b\u304c\u308b\u3053\u3068\u3092\u7406\u89e3\u3057\u3066\u304a\u304f\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n 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