摘要
目的探讨成人斯蒂尔病(AOSD)的临床特点、治疗及预后转归情况,以提高对该病的认识。方法回顾性分析83例成人斯蒂尔病患者的临床资料并进行随访。结果发热(92.77%)、皮疹(89.16%)、关节痛(54.22%)、咽痛(85.54%)是AOSD患者最常见的四大主要症状。实验室检查有白细胞增多(74.70%)、ESR增快(97.80%)、CRP升高(98.80%)、肝功能损害(18.07%)、血清铁蛋白升高(97.59%),59.04%患者仅给予肾上腺皮质激素治疗即有效,37.35%的患者需再加用1种或1种以上免疫抑制剂。随访63例患者,获长期缓解56%,反复发作25.30%,病情呈慢性持续性16%。结论 AOSD是一种以发热、皮疹、关节痛、白细胞增多为主要特征的自身免疫性疾病,预后良好,多数患者用激素治疗有效,但对以关节炎表现为主以及合并内脏损害的患者应尽早使用免疫抑制药,以控制病情。
Objective To describe the clinical and laboratory features, treatment and prognosis of patients with adult onset Still＇s disease （AOSD）. Methods Clinical and laboratory features were retrospectively recorded in 83 patients fulfilling the Yamaguchi criteria. Results Common clinical features were fever （92.77%）, rash （89.16%）, arthritis （54.22%） and sore throat（85.54% ）. The laboratory findings were as follows： leukocytosis （74.70%）, increased erythrocyte sedimentation rate（97.80% ）, elevated C -reactive protein（98. 80% ）, elevated transaminase concentrations （18.07%）, and hyper serum ferritin （97.59%）. As for the treatment received, high -dose corticosteroids （0.5 - 1 mg/kg/day） controlled the disease in 49 patients （59.04%） and 31 patients （37.35%） required an additional disease modifying agent, usually methotrexate. The course of the disease was monocyclic in 56% of the patients, polycyclic in 25.3%, and chronic articular in 16%. Conclusion The major clinical features in AOSD are fever, rash, arthritis and leukocytosis. Most patients could be controlled by corticosteroids and have a good prognosis, only a few of them require the use of disease modifying agent.
出处
《安徽医学》
2012年第12期1646-1648,共3页
Anhui Medical Journal
关键词
成人斯蒂尔病
临床特征
疾病转归
Adult - onset Still＇s disease
Clinical feature
Prognosis
