复发性多软骨炎气道受累的临床特征及其早期诊断  

Clinical characteristics and early diagnosis of patients with relapsing polychondritis with airway involvement

作　　者：陈楠[1] 王振刚[1] 崔莉[1] 高圆[1] 王艳妮[1] 

机构地区：[1]首都医科大学附属北京同仁医院风湿免疫科,北京100730

出　　处：《中国医刊》2016年第11期27-31,共5页Chinese Journal of Medicine

摘　　要：目的探讨复发性多软骨炎(relapsing polychondritis,RP)气道受累的临床特征及早期诊断。方法将2010年1月至2016年2月于本院就诊的累及气道的70例RP患者分为气道首发组及非气道首发组,分析其临床特点及辅助检查的必要性。结果前三位气道表现为呼吸困难或喘憋55例(78.6%)、声嘶40例(57.1%)、咳嗽咳痰40例(57.1%)。喉、气管、主支气管同时受累最常见(24例,34.3%)。气道首发组喉部受累及确诊前气管切开比例较高。10.0%的患者无呼吸道症状,但喉气管CT异常。分别有40.0%及51.4%的患者无症状但听力及前庭功能检查阳性。结论 RP首发气道受累者气道病变广泛且进展迅速。无症状气道及内耳损伤常见,重视客观检查可提高诊断率。Objective To investigate the clinical characteristics and early diagnosis of patients with relapsing polychondritis（RP） with airway involvement.Method According to the presenting symptom,seventy RP patients with airway involvement were divided into two groups,airway-onset group and non-airway-onset group.The clinical characteristics and necessity of assistant examinations were discussed.Result Dyspnea and stridor was the most common symptom of airway involvement in 55 patients（78.6%）,followed by hoarseness in 40 patients（57.1%）,cough and sputum in 40 patients（57.1%）.Larynx,trachea and main bronchi were affected simultaneously in 24 patients（34.3%）,being the most common pattern.Larynx involvement was more frequent in airway-onset group,with a higher tracheostomy rate before diagnosis.Airway chondritis was evident on CT scan characterized by tracheobronchial wall thickening or calcification in 10.0% of the patients despite the absence of airway symptoms.Asymptomatic hearing loss and vestibular dysfunction were seen in 40.0% and 51.4% of the patients respectively.Conclusion Airway involvement is common in RP.Airway chondritis may be asymptomatic in some patients.More widespread airway involvement and aggressive disease course are seen in those who presenting with airway chondritis.Asymptomatic airway involvement and inner ear damage are frequent.Radiological examination and functional evaluation are essential for the early recognition of RP.

关 键 词：复发性多软骨炎 气道软骨炎 早期诊断 

分 类 号：R593.9[医药卫生—内科学]