SAPHO综合征耳鼻咽喉表现的临床研究  

Otorhinolaryngologic Manifestations of SAPHO Syndrome

作　　者：王轶[1] 栾岚[1] 赵杨[1] 奥登苏日塔 王希 李忱[2] 张文[3] 高志强[1] Wang Yi;Luan Lan;Zhao Yang(Department of Otolaryngology,Traditional Chinese Medicine&Rheumatology and Immunology.Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,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耳鼻咽喉科,100730 [2]中国医学科学院/北京协和医学院北京协和医院中医科,100730 [3]中国医学科学院/北京协和医学院北京协和医院免疫科,100730

出　　处：《医学研究杂志》2021年第1期42-46,共5页Journal of Medical Research

基　　金：国家重点研发计划项目罕见病临床队列研究项目(2016YFC0901500);中国医学科学院医学与健康科技创新工程基金资助项目(2017-12N-3-001);首都卫生科研专项基金资助项目(2016-4-40112)。

摘　　要：目的观察SAPHO综合征患者的耳鼻咽喉表现以及难治性SAPHO患者扁桃体切除术后效果,探讨SAPHO可能的病因和治疗方法。方法通过横断面临床研究观察135例SAPHO患者的耳鼻咽喉主客观表现,对难治性病例合并慢性扁桃体炎患者53例扁桃体切除术后皮肤损伤(以下简称皮损)、骨痛效果进行评估。结果耳郭/外耳道脓疱疹、化脓性外耳道炎、中耳炎、鼻炎、鼻窦炎、鼻咽炎、慢性扁桃体炎和慢性咽喉炎发生率分别为16.3%、5.9%、20.0%、8.1%、15.6%、28.1%、48.1%和53.3%。扁桃体切除术后3个月、1年时的皮损、骨痛消失率分别为18%和33%、57%和77%。结论本研究发现SAPHO患者耳鼻咽喉炎症表现突出,约半数患者有慢性扁桃体炎和(或)慢性咽喉炎。扁桃体切除术后1年时患者骨痛、皮损消失率高。推测扁桃体炎可能是SAPHO的诱发因素之一。扁桃体切除术可能成为SAPHO候选治疗方法之一。Objective Toreport otolaryngologic manifestationsin SAPHOsyndromeand the clinical outcome of tonsillectomy in refractory cases,to discuss the possible etiologyand treatment for SAPHO.Methods This cross-sectionalstudywasto recordthe subjective and objective otolaryngologic manifestations in135 cases with SAPHO syndrome.Fifty-three refractory cases to conventional drugs with chronic tonsillitis who received tonsillectomy at least 3 months were evaluated the skinlesions and bone pain before and after tonsillectomy.Results There were pustules in the auricleand auditory canal in 16.3%patients,suppurative otitis externa in 5.9%,otitis media in 20.0%.Mild rhinitis and sinusitiswere found in 8.1%and 15.6%respectively.Nasopharyngitis was found in 28.1%.The prevalence of chronic tonsillitis and laryngopharyngitis were as high as up to 48.1%and 53.3%respectively.In 53 patients who received tonsillectomy for more than 3 months,the disappearance rates of skin lesions and bone pain were 18%and 33%respectively after 3 months of follow-up,and 57%and 77%respectively one year after tonsillectomy.Conclusion This is the first report of cross-sectional study of otolaryngologic manifestations in SAPHO syndromein the world.Inflammation of the ear nose and throat was prominent.The prevalence of chronic tonsillitis and laryngopharyngitiswasabout half of the cases.Tonsillectomy resolved skin lesions and bone pain in mostof the cases in a year follow-up.SAPHO may be a tonsil related disease.Tonsillectomymaybe a treatment choice for SAPHO,especially in the refractory cases.

关 键 词：SAPHO综合征 耳鼻咽喉表现 扁桃体炎 扁桃体切除术 

分 类 号：R593[医药卫生—内科学]