以关节病变为首发表现的复发性多软骨炎临床特征分析  

Clinical Features of Relapsing Polychondritis Patients Presented with Arthropathy

作　　者：曹晓宇[1,2] 赵久良 徐东[1] 侯勇[1] 张烜[1] 赵岩[1] 曾小峰[1] 张奉春[1] CAO Xiaoyu;ZHAO Jiuliang;XU Dong;HOU Yong;ZHANG Xuan;ZHAO Yan;ZENG Xiaofeng;ZHANG Fengchun(Department of Rheumatology and Clinical Immunology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of Rheumatology and Clinical Immunology,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院风湿免疫科,北京100730 [2]首都医科大学附属北京天坛医院风湿免疫科,北京100070

出　　处：《中国医学科学院学报》2020年第6期717-722,共6页Acta Academiae Medicinae Sinicae

基　　金：国家自然科学基金(81671614);中国医学科学院医学与健康科技创新工程(2017-12M-3-001)。

摘　　要：目的探讨以关节病变起病的复发性多软骨炎(RP)患者的临床特征。方法回顾性分析2005年12月至2019年2月北京协和医院住院的201例RP患者临床资料。除外16例合并其他自身免疫性疾病、肿瘤的RP患者后,共纳入185例RP患者。其中16例RP患者以关节病变起病,169例以非关节病变起病。比较以关节病变起病的RP患者和非关节病变起病的RP患者的人口学特点、临床表现、实验室指标、死亡预后的差异。结果以关节病变起病的RP患者中,5例患者最初被误诊为类风湿关节炎。与非关节病变起病的RP患者相比,以关节病变起病的RP患者病程更长[(37.50±66.50)个月比(9.00±11.00)个月,z=-3.186,P=0.001],诊断延迟时间更长[(24.00±41.25)个月比(7.00±9.00)个月,z=-2.890,P=0.004];更容易出现眼(62.50%比36.09%,χ^2=4.309,P=0.038)、神经系统(43.75%比15.38%,χ^2=6.205,P=0.013)受累。结论以关节病变起病的RP患者容易被误诊为类风湿关节炎,且以关节病变起病的RP患者病程及诊断延迟时间更长,更常出现眼、神经系统受累。Objective To explore the clinical characteristics of relapsing polychondritis(RP)patients presented with arthropathy.Methods We retrospectively analyzed the clinical data of 201 RP patients who were hospitalized in our center between December 2005 and February 2019.After 16 patients with co-existing other autoimmune diseases and malignancies were ruled out,185 RP patients entered the final analysis,among whom 16 RP patients were presented with arthropathy and 169 without arthropathy.The demographic data,clinical manifestations,laboratory findings,and prognosis were compared between these two groups.Results Five of the 16 RP patients with arthropathy at presentation were misdiagnosed as rheumatoid arthritis.Compared with RP patients without arthropathy at presentation,RP patients with arthropathy at presentation had a longer disease course[(37.50±66.50)months vs.(9.00±11.00)months,z=-3.186,P=0.001],longer time of diagnostic delay[(24.00±41.25)months vs.(7.00±9.00)months,z=-2.890,P=0.004],and higher incidence of eye(62.50%vs.36.09%,χ^2=4.309,P=0.038)and nervous system involvements(43.75%vs.15.38%,χ^2=6.205,P=0.013).Conclusions RP patients with arthropathy at presentation are most likely to be misdiagnosed as rheumatoid arthritis.These patients are characterized by longer disease course and diagnostic delay and more frequrent eye and nervous system involvements.

关 键 词：复发性多软骨炎 关节病变 诊断延迟 

分 类 号：R593.2[医药卫生—内科学]