河南淇县宋庄东周墓葬一例殉人骨骼上发现疑似类风湿关节炎

doi:10.16359/j.1000-3193/AAS.2021.0033

摘要/Abstract

摘要：

本文介绍了河南淇县宋庄东周贵族墓葬的一例殉人骨骼标本M9-X2,对标本中疑似类风湿关节炎的表现特征进行描述和分析。该殉人的肩、肘、手腕、髋、膝、脚踝等多处关节面的骨质存在对称性侵蚀。相关的X光片显示,侵蚀关节附近有骨质疏松。因未保存全部脊椎和两侧骶髂关节,虽然无法完全排除血清阴性脊椎关节炎的可能,但是对比多种关节疾病的不同骨骼病变特征后认为,该殉人骨质病变更倾向于类风湿关节炎。

关键词: 类风湿关节炎, 侵蚀, 淇县, 东周墓葬, 殉人

Abstract:

The purpose of this study is to describe and analyze the evidence for rheumatoid arthritis in a sample of human sacrifice skeleton uncovered from a noble tomb of eastern Zhou period at Qixian Songzhuang cemetery in Henan Province. The human sacrifice is characterized by numerous symmetrical surface erosions in the joints of the shoulder, elbow, wrist and hand, hip, knee, ankle, and foot. Radiographs revealed that osteoporosis was evident in the joints with erosions. The possibility of seronegative spondyloarthropathies cannot be completely ruled out due to the lack of preservation of all the vertebrae and both sacroiliac joints. However, by comparing the major differential signs for diagnosing various joint diseases, rheumatoid arthritis is suggested as the most probable cause of this pathology in the human sacrifice skeleton.

Key words: Rheumatoid arthritis, Erosion, Qixian, Eastern Zhou Tomb, Human sacrifice

中图分类号:

Q987

孙蕾. 河南淇县宋庄东周墓葬一例殉人骨骼上发现疑似类风湿关节炎[J]. 人类学学报, 2022, 41(02): 248-260.

SUN Lei. Possible rheumatoid arthritis found in a human sacrifice skeleton from the Eastern Zhou tomb of Songzhuang village, Qi county, Henan province[J]. Acta Anthropologica Sinica, 2022, 41(02): 248-260.

图/表 8

图1 宋庄墓地M9殉人X1和X2（环置于墓主棺椁的周围）

Fig.1 Human sacrifices X1 and X2 at the tomb M9 of Songzhuang cemetery (around the tomb master)

图2 M9-X2人骨保存情况及侵蚀分布 1. 灰色部分为缺失骨骼,黑点为侵蚀的具体部位Grey areas indicate missing bones, black points are the bones affected by erosions;2. 类风湿关节炎受累区域分布图Distribution of joints involvement for rheumatoid arthritis

Fig.2 Preserved elements of the skeleton M9-X2 and skeletal distribution of erosions

图3 肩肘关节的侵蚀 1、2. 右侧肱骨头变形的前面观和侧面观Squashed head of right humerus, anterior and lateral views;3、4. 右侧与左侧关节盂Right and left glenoid cavity;5、6. 右侧与左侧肱骨远端Right and left humerus;7. 右侧尺骨Right ulna

Fig.3 Erosions of shoulder and elbow joints

图4 手腕关节的侵蚀 1、2.右侧第三掌骨的头部和基底部Head and base of right third metacarpal;3、4.左侧第二近节指骨的头部和基底部Head and base of left second proximal phalange;5.右侧头状骨的三角骨方向观Right capitate, view from trapezoid;6.左侧手舟状骨Left scaphoid

Fig.4 Erosions of wrist and hand joints

图5 髋膝关节的侵蚀 1、2.左侧与右侧髋臼Left and right acetabular;3、4.右侧股骨头及其X光片Right head of femur and its radiograph;5.右侧股骨头细部Detail of right head of femur;6. 左侧髌骨的髁面Articular surface of left patella;7.右侧股骨的髌面Patellar surface of right femur

Fig.5 Erosions of hip and knee joints

图6 胫骨远近端关节面的侵蚀 1、2.左侧与右侧胫骨近端Left and right proximal tibia;3、4.右侧与左侧胫骨远端 Right and left distal tibia

Fig.6 Erosions of tibia joints

图7 踝关节面的侵蚀 1、2.距骨背面观和X光片 Talus, dorsal views, their radiograph;3、4.右侧跟骨背面观及X光片Dorsal view of right calcaneus and its radiograph

Fig.7 Erosions of ankle joints

图8 肱骨与胫骨的X光片 1.左右侧肱骨Left and right humerus;2.右侧胫骨 Right tibia

Fig.8 Radiographs of humerus and tibia

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