強直性脊椎炎の心臓合併症に対する性の影響—自験例を含む95症例の文献的考察

Sex influence on the cardiac complication of ankylosing spondylitis:Analysis of 95 cases of ankylosing spondylitis including our case

　強直性脊椎炎は本邦では比較的稀な疾患で，ときに大動脈弁閉鎖不全などの弁膜症や伝導路障害を合併し，男女比は約4.5：1と男性に多いことが知られている。本邦では心臓合併症を伴った本症は，自験例を含めて5例しか報告がなく，すべて男性であったことから，心臓合併症を伴った強直性脊椎炎に性差がどのように影響しているか，本邦例と欧米例を含む症例報告95例で検討した。心臓合併症例では99％が男性で，一般の強直性脊椎炎患者における男性の率に比べ有意に男性が多かった（p＜0.0001）。本症の心臓合併症例を伝導路障害合併例と弁膜症合併例に分けて検討しても，同様に一般の強直性脊椎炎患者における男性の率に比べ有意に男性が多かった（p＜0.0001）。以上より本症に伴う心臓合併症は男性に特徴的なものと考えられた。またこの性差は心臓合併症を伴う他の疾患との鑑別に有用と思われる。

Ankylosing spondylitis is apparently rare among Japanese and it is known that this disease is commo-ner in males than in females. The male to female ratio among general ankylosing spondylitis is 4. 5: 1. The cardiac conduction abnormalities, aortic insu-fficiency and mitral insufficiency are sometimes associated with this disease. We analysed the in-fluence of sex on the development of these cardiac complications using 95 reported cases of ankylosing spondylitis including our case. Among the ankylo-sing spondylitis patients who were accompanied with cardiac complication, 99% were male. This frequ-ency is significantly high compared with that found in general ankylosing spondylitis (p＜0.0001). The cardiac complication associated with this disease seems to be characteristic for males. This sex diffe-rence is useful for differential diagnosis from various diseases which accompany these cardiac complica-tions. The mechanism of sex influence on the car-diac complication of ankylosing spondylitis was also discussed.