晚期类风湿关节炎16例临床分析  

Clinical Analysis in Advanced Rheumatoid Arthritis (Report of 16 cases)

作　　者：高岚[1] 吴昆[1] 李青[1] 王永福[1] 贺其图[1] 

机构地区：[1]包头医学院第一附属医院风湿免疫科,内蒙古包头014010

出　　处：《内蒙古医学杂志》2007年第2期133-135,共3页Inner Mongolia Medical Journal

摘　　要：目的：分析晚期类风湿关节炎（RA）的临床特点。方法：回顾性分析我院2002年1月～2006年1月住院的16例晚期RA患者的临床特点、炎性指标及治疗情况，与49例非晚期组进行对比分析。结果：在临床表现上。晚期组与非晚期组比较：病程分别为14．0±7．28年、2．68±4．54年（P〈0．05）；女性所占比例分别为100％，67．3％（P〈0．05）；关节畸形个数分别为2．54±3．05、2．18±2．50（P〈0．05）；关节功能分级分别为3．31±0．60、2．83±0．89（P〈0．05），有显著性差异。晚期组血管炎（25．0％）、间质性肺病（6．3％）和继发性干燥综合征的发生率较高，其中继发性干燥综合征发生率晚期组与非晚期组分别为43．8％、14．3％（P〈0．05），有显著性差异。在炎性指标中C反应蛋白、血沉、RF、球蛋白、血小板计数、免疫球蛋白两组无显著差异（P〉0．05），但血沉（67．37±30．83mm／h）、C反应蛋白（37．83±37．91μg／dl）、RF（175．93±181．94μg／dl）明显高于正常。治疗上，晚期组37．5％患者使用中大量激素（非晚期组为65．3％，P〈0．05），68．8％的晚期组患者使用1种以上慢作用药物（非晚期组为98．0％，P〈0．05），有显著性差异。结论：晚期RA以女性多见，间接提示女性患者预后差。病程长、畸形的关节个数较多而导致关节功能明显下降，生活明显受限。血沉、C反应蛋白、RF明显高于正常，血管炎、间质性肺炎和继发性干燥综合征的发生率较高，提示关节外活动。治疗上，不仅仅对症治疗，常使用中、大剂量激素或小剂量激素治疗，并使用慢作用药物治疗。Objective： To analyze the clinical features of advanced rheumatoid arthritis （RA）. Methods： From Jan. 2002 to Jan. 2006, the clinical features, infamatory index and therapy in 16 cases of advanced RA were retrospectively analyzed and compared with those in 49 casesofnon - advanced RA. Results： Compared with group with non - advanced RA, the course of disease was longer, female and the number of deformed articulus was more and the level of joint function was higher in group with advanced RA （P〈0.05）, showing significant diffence In group with advanced RA, the incidence of vasculitis, interstitial lung disease and secondary sjogren syndrome was higher than that in group with non - advanced RA There was no difference in the levels of c - reactive protein, blood sedimentation, RF, globulin, blood platelets count and immllnoglobulin be tween two groups, but that of blood sedimentation, c- reactive protein and RF in group with RA was higher than that in nor mals. There were significant difference in dosage of hormone and numbers of medicines between two groups. Conclusion： Major patients with advanced RA are female, which indicates the prognosis.of female patients with RA was worse The longer course of disease, deformed joint may induce decreasing joint funtion and limited life. The higher blood sedimentation, c - reactive protein and RF, and developed vasculitis, intestitial lung disease and secondary Sjogren syndrome indicate abarticular activity The medication includes symptomatic treatment,various dosage of hormone and slowly effective medicines.

关 键 词：类风湿关节炎 晚期 临床指标 实验室指标 

分 类 号：R593.22[医药卫生—内科学]