王青波　徐海东　刘振陶　曹盛楠　王从安　孙国栋

[關键词] 强直性;脊柱炎;误诊;计量学分析

[中图分类号] R68          [文献标识码] B          [文章编号] 1673-9701（2021）17-0095-04

Bibliometric analysis of misdiagnosis of ankylosing spondylitis

WANG Qingbo1   XU Haidong2   LIU Zhentao2   CAO Shengnan3   WANG Cong′an4   SUN Guodong2，5

1.Shandong First Medical University（Shandong Academy of Medical Sciences），Ji′nan   250031，China;2.Department of Rehabilitation Medicine，the Third Affiliated Hospital of Shandong First Medical University，Ji′nan   250031，China; 3.School of Acupuncture and Tuina，Shandong University of Traditional Chinese Medicine，Ji′nan   250355，China;4.Department of Rehabilitation Medicine，Neck，Shoulder，Waist and Leg Pain Hospital Affiliated to Shandong First Medical University，Ji′nan   250014，China;5.Institute of Medical Engineering and Translational Medicine，Tianjin University，Tianjin   300072，China

[Abstract] Objective To understand the misdiagnosis of AS and improve the early diagnosis rate by analyzing the literature related to the misdiagnosis of ankylosing spondylitis（AS）. Methods The literature related to AS misdiagnosis included in the China Academic Journal Full-text Database（CNKI） from 1989 to 2020 were studied， and the characteristics of AS misdiagnosis and the types of diseases easily misdiagnosed were analyzed. Results 1.216 documents related to misdiagnosis of AS were initially screened， and the number of misdiagnosed cases was 7503. One hundred sixty-four documents misdiagnosed AS as other diseases， with a total of 7328 misdiagnosed cases. Fifty-three documents misdiagnosed other diseases as AS， with 175 misdiagnosed cases. Some patients were misdiagnosed many times during treatment. 2.The first case of misdiagnosis of AS was reported in 1989， and the peak of misdiagnosed cases reached in 2006. Among the misdiagnosed cases of AS， there were relatively more cases of AS misdiagnosed as other diseases， relatively few cases of other diseases misdiagnosed as AS. 3.In the diagnosis process， AS easily confused with rheumatoid arthritis， followed by rheumatoid arthritis， lumbar disc herniation， lumbar muscle strain and other diseases. Conclusion There are many kinds of diseases that are easily confused with AS. Unclear etiology， insidious disease， imperfect diagnostic criteria， lack of sensitive diagnostic techniques that can reflect early lesions， and lack of understanding by clinicians of AS are important reasons for the misdiagnosis of the disease. Due to the limitation of the level of understanding， clinicians need to improve the level of diagnosis and treatment， combined with the symptoms and signs of patients， use imaging， laboratory examination and other methods to comprehensively analyze and make in-depth diagnosis， and to differentiate from other diseases to avoid misdiagnosis. Due to the limitation of the level of understanding， clinicians need to improve the level of diagnosis and treatment， to comprehensively analyze and make in-depth diagnosis combining the symptoms and signs of patients using imaging， laboratory examinations and other methods， and to differentiate from other diseases to avoid misdiagnosis.

[Key words] Ankylosing; Spondylitis; Misdiagnosis; Bibliometric analysis

强直性脊柱炎（Ankylosing spondylitis，AS）是一种血清反应阴性，以中轴关节慢性炎症为主，也可累及内脏及其他组织的慢性进展性风湿免疫性疾病。主要表现为受累中轴关节和外周关节的疼痛、强直、功能障碍等。发病与遗传、感染、内分泌失调、创伤、自身免疫功能紊乱等有关。本病多呈进行性发展趋势，且病情中后期不能逆转，致残率很高，严重影响患者的身心健康，给社会及患者家庭带来沉重的负担。因此，AS的早期预防、早期诊断、早期治疗，对患者治疗及预后起着至关重要的作用，可显著减轻患者的痛苦，大大降低患者的致残率。本研究通过对AS误诊相关文献进行分析，与其他多种疾病相鉴别，避免误诊，提高早期诊断率，现报道如下。

1 资料与方法

1.1 检索策略

1.1.1 数据库  中国期刊全文数据库（CNKI）。

1.1.2 检索方法  CNKI采用“主题（强直性脊柱炎）AND 主题（误诊）”。

1.1.3 检索导航范围  医药卫生科技。

1.1.4 原文获取途径  检索电子期刊全文数据库。

1.2 文献纳入标准

符合以下所有条件的文献被纳入：①与强直性脊柱炎误诊有关的临床病例报道文献;②文献发表年限1989年1月1日至2020年12月31日;③中文文献、外文文献。

1.3 文献排除标准

符合其中一个条件的文献被排除：①与AS误诊不相关的临床报道文献;②无统计意义的综述性文献;③无法获得全文的文献;④检索中出现重复的文献只选其中1个。

1.4方法

1.4.1 主要分析指标  文献发表时间、不同时间AS误诊病例数、需要与AS相鉴别的疾病类型、误诊的原因。……