AS 的患病率与 HLA-B27 在人群中的阳性率相关。据估计,每 10,000 人中 AS 的平均患病率约为(来自于 36 个符合条件的研究)欧洲 23.8 例、亚洲 16.7 例、北美洲 31.9 例、拉丁美洲 10.2 例。通过研究规模加权计算出的额外估计数据分别为欧洲 18.6 例、亚洲 18 例和拉丁美洲 12.2 例。[16]Dean LE, Jones GT, MacDonald AG, et al. Global prevalence of ankylosing spondylitis. Rheumatology (Oxford). 2014 Apr;53(4):650-7.http://rheumatology.oxfordjournals.org/content/53/4/650.longhttp://www.ncbi.nlm.nih.gov/pubmed/24324212?tool=bestpractice.com 在美国,AS的年发病率为7.3/10万。[17]Carbone LD, Cooper C, Michet CJ, et al. Ankylosing spondylitis in Rochester, Minnesota, 1935-1989. Is the epidemiology changing? Arthritis Rheum. 1992 Dec;35(12):1476-82.http://www.ncbi.nlm.nih.gov/pubmed/1472124?tool=bestpractice.com 欧洲的流行病学有效数据显示,在意大利AS的患病率为0.37%, 法国为0.3% ,德国为0.86% 。[18]De Angelis R, Salaffi F, Grassi W. Prevalence of spondyloarthropathies in an Italian population sample: a regional community-based study. Scand J Rheumatol. 2007 Jan-Feb;36(1):14-21.https://www.tandfonline.com/doi/full/10.1080/03009740600904243http://www.ncbi.nlm.nih.gov/pubmed/17454930?tool=bestpractice.com[19]Saraux A, Guillemin F, Guggenbuhl P, et al. Prevalence of spondyloarthropathies in France: 2001. Ann Rheum Dis. 2005 Oct;64(10):1431-5.https://ard.bmj.com/content/64/10/1431.longhttp://www.ncbi.nlm.nih.gov/pubmed/15817661?tool=bestpractice.com[20]Braun J, Bollow M, Remlinger G, et al. Prevalence of spondylarthropathies in HLA-B27 positive and negative blood donors. Arthritis Rheum. 1998 Jan;41(1):58-67.http://www.ncbi.nlm.nih.gov/pubmed/9433870?tool=bestpractice.com 日本[21]Hukuda S, Minami M, Saito T, et al. Spondyloarthropathies in Japan: nationwide questionnaire survey performed by the Japan Ankylosing Spondylitis Society. J Rheumatol. 2001 Mar;28(3):554-9.http://www.ncbi.nlm.nih.gov/pubmed/11296958?tool=bestpractice.com 和希腊的 AS 患病率较低。[22]Alamanos Y, Papadopoulos NG, Voulgari PV, et al. Epidemiology of ankylosing spondylitis in Northwest Greece, 1983-2002. Rheumatology (Oxford). 2004 May;43(5):615-8.http://rheumatology.oxfordjournals.org/content/43/5/615.fullhttp://www.ncbi.nlm.nih.gov/pubmed/14872102?tool=bestpractice.com 本病发病年龄常在10-20岁。[23]Feldtkeller E, Bruckel J, Khan MA. Scientific contributions of ankylosing spondylitis patient advocacy groups. Curr Opin Rheumatol. 2000 Jul;12(4):239-47.http://www.ncbi.nlm.nih.gov/pubmed/10910174?tool=bestpractice.com 男性较女性更易患病,男女比例为2.5:1。[24]Kennedy LG, Will R, Calin A. Sex ratio in the spondyloarthropathies and its relationship to phenotypic expression, mode of inheritance and age at onset. J Rheumatol. 1993 Nov;20(11):1900-4.http://www.ncbi.nlm.nih.gov/pubmed/8308776?tool=bestpractice.com[25]Will R, Edmunds L, Elswood J, et al. Is there sexual inequality in ankylosing spondylitis? A study of 498 women and 1202 men. J Rheumatol. 1990 Dec;17(12):1649-52.http://www.ncbi.nlm.nih.gov/pubmed/2084239?tool=bestpractice.com[26]Moll JM, Wright V. New York clinical criteria for ankylosing spondylitis. A statistical evaluation. Ann Rheum Dis. 1973 Jul;32(4):354-63.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1006116/pdf/annrheumd00016-0073.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/4269429?tool=bestpractice.com 症状出现与疾病确诊约有 8 年的时间间隔,[27]Braun J, Sieper J. Inception cohorts for spondyloarthropathies [in German]. Z Rheumatol. 2000 Apr;59(2):117-21.http://www.ncbi.nlm.nih.gov/pubmed/10868019?tool=bestpractice.com 常导致患者的临床结局更差。[14]Stone M, Warren RW, Bruckel J, et al. Juvenile-onset ankylosing spondylitis is associated with worse functional outcomes than adult-onset ankylosing spondylitis. Arthritis Rheum. 2005 Jun 15;53(3):445-51.http://onlinelibrary.wiley.com/doi/10.1002/art.21174/fullhttp://www.ncbi.nlm.nih.gov/pubmed/15934110?tool=bestpractice.com[27]Braun J, Sieper J. Inception cohorts for spondyloarthropathies [in German]. Z Rheumatol. 2000 Apr;59(2):117-21.http://www.ncbi.nlm.nih.gov/pubmed/10868019?tool=bestpractice.com 幼年发病的AS外周关节受累更严重且预后更差。[14]Stone M, Warren RW, Bruckel J, et al. Juvenile-onset ankylosing spondylitis is associated with worse functional outcomes than adult-onset ankylosing spondylitis. Arthritis Rheum. 2005 Jun 15;53(3):445-51.http://onlinelibrary.wiley.com/doi/10.1002/art.21174/fullhttp://www.ncbi.nlm.nih.gov/pubmed/15934110?tool=bestpractice.com[27]Braun J, Sieper J. Inception cohorts for spondyloarthropathies [in German]. Z Rheumatol. 2000 Apr;59(2):117-21.http://www.ncbi.nlm.nih.gov/pubmed/10868019?tool=bestpractice.com 患AS的高加索人中约9%至21%为幼年发病。 [14]Stone M, Warren RW, Bruckel J, et al. Juvenile-onset ankylosing spondylitis is associated with worse functional outcomes than adult-onset ankylosing spondylitis. Arthritis Rheum. 2005 Jun 15;53(3):445-51.http://onlinelibrary.wiley.com/doi/10.1002/art.21174/fullhttp://www.ncbi.nlm.nih.gov/pubmed/15934110?tool=bestpractice.com AS常与银屑病或炎性肠病相关(约10% 的AS患者 )。约 60%的患者可通过组织学检查检测出亚临床的炎性肠病。[3]Rudwaleit M, Baeten D. Ankylosing spondylitis and bowel disease. Best Pract Res Clin Rheumatol. 2006 Jun;20(3):451-71.http://www.ncbi.nlm.nih.gov/pubmed/16777576?tool=bestpractice.com
数十年之前,男性与女性的 AS 患病率之比约为 10:1,这可能是因为女性的疾病检出率明显较低。最近的研究估算显示,该地区患者中男女性别比例约为 2.5:1,这说明近年来不同性别之间的延误诊断率趋于近似。[15]Lee W, Reveille JD, Weisman MH. Women with ankylosing spondylitis: a review. Arthritis Rheum. 2008 Mar 15;59(3):449-54.http://onlinelibrary.wiley.com/doi/10.1002/art.23321/fullhttp://www.ncbi.nlm.nih.gov/pubmed/18311755?tool=bestpractice.com