目的 探讨氟骨症与强直性脊柱炎(ankylosing spondylitis，AS) 的鉴别诊断要点。 方法 回顾分析我省某氟骨症专科医院提供的62例氟骨症与同期就诊我院54例AS的临床资料。结果 氟骨症患者发病平均年龄（42.9±6.66）岁，明显大于AS患者［（18±7.57）岁］，差异有统计学意义(P <0.01)；外周关节疼痛数目≥3者所占比例明显大于AS组（74.2% vs 3.7%，P<0.01），活动后加重所占比例明显高于AS组（83.9% vs 5.56%，P<0.01），HLA-B27阳性所占比例明显低于AS组（3.2% vs 90.7%, P<0.01），四肢骨病变、外周关节病变及骨间膜钙化比例均明显高于AS组（P<0.01），脊柱竹节样变比例高于AS组（61.3% vs 22.2%，P<0.05），骨质破坏比例明显低于AS组(P<0.01)。 结论 氟骨症与强直性脊柱炎的鉴别，应从流行病学、临床表现、HLA-B27检测及影像学检查等综合考虑，以减少误诊。

Objective To explore the differential diagnosis between skeletal fluorosis and ankylosing spondylitis. Methods 62 patients of skeletal fluorosis provided by a specialized hospital in Shanxi province and 54 AS patients admitted to Shanxi Provincial Corps Hospital from August 2009 to March 2010 were retrospectively analyzed. Results The age of onset（42.9±6.66） and number of peripheral joint pain (≥3)in skeletal fluorosis group were above those in AS group, and the difference was statistically significant（P <0.01）. The  rate of  deterioration after exercise( 83.9%,52 cases）was higher than that in AS group( 5.56%, 3 cases)（P<0.01）. The positive rate of HLA-B27 in skeletal fluorosis group  (3.2% , 2 cases)  was lower than that in AS group( 90.7% ,49 cases)（P<0.01）. The rate of limb bone lesions  (100%, 62 cases) , peripheral  joint  disease（90.3%, 56cases）  and interosseous membrane calcification（27.4%, 17 cases）was higher than in AS group（P<0.01）. The rate of spinal slub amyloidosis（61.3%, 38 cases）was higher than that in AS group (22.2%, 12cases)（P<0.05）. The rate of bone destruction in skeletal fluorosis group（0%,0 cases）was lower than that in AS group(29.6%,16 cases) (P<0.01).  Conclusions Correct diagnosis should be made based on epidemiology、clinical manifestations、HLA-B27 test and imaging manifestations   between skeletal  fluorosis  and ankylosing  spondylitis.