伴眼部损害复发性多软骨炎192例临床分析及Rose标准应用  

The clinical features of ocular involvement and the application of Rose criteria in patients with relapsing polychondritis

作　　者：王振刚[1] 曹凯 王艳妮[1] 陈楠[1] Wang Zhengang;Cao Kai;Wang Yanni;Chen Nan(Department of Rheumatology and Clinical Immunology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Department of Ophthalmology,Beijing Institute of Ophthalmology,Beijing Tongren Hospital,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院风湿免疫科,100730 [2]北京市眼科研究所北京同仁医院眼科,100730

出　　处：《中华风湿病学杂志》2021年第4期247-252,共6页Chinese Journal of Rheumatology

摘　　要：目的探讨伴眼部损害复发性多软骨炎(RP)的临床分型和Rose标准的应用。方法连续收集符合至少1条Michet主要条件且伴眼部损害的RP患者,分析其临床特点、病情评价及Rose标准应用情况。人口学资料以百分比表示;各发病类型之间的差异行Mann Whitney U检验。组间的多重比较采用错误发现率(FDR)方法对P值进行校正。结果共入选192例患者,男性98例,女性94例。发病年龄0.5~79岁,平均(42±14)岁;病程0.5~600个月,中位数为13个月;RP病情活动指数(RPDAI)9~74,中位数为39;RP器官损害指数(RPODI)0.1~108,中位数为2.5;RP损害指数(RPDAM)1~6,中位数为3;鼻软骨炎组与外耳软骨炎组(Z=10.775,P<0.01)及头颈外受累组(Z=9.277,P<0.01)之间的病程中位数、鼻软骨炎组与外耳软骨炎组(Z=7.999,P=0.031)及头颈外受累组(Z=8.115,P=0.030)之间的RPODI中位数、眼部受累组与气道受累组之间的RPDAM中位数差异均具有统计学意义;前3位的起病类型是眼部受累(50.0%)、外耳软骨炎(21.4%)及气道软骨炎(13.5%);病程中眼部受累(100%)、气道受累(75.0%)及内耳损害(69.3%)为前3位受累器官;眼部病变累及眼球的各个部位;单一部位受累115例(59.9%);77例(40.1%)为多部位受累。应用Rose标准后,171例完全符合Michet标准患者的诊断得到加强,21例(10.9%)符合Michet标准的患者符合Rose标准;依据耳廓及气道受累的临床分型提示鞍鼻、气道及中耳受累的关系。对易受累器官的主动筛查率可以提高RP的诊断率。结论RP的眼受累涉及眼球的各个部位;对此组患者应关注气道及内耳受累的筛查;Rose标准的应用值得进一步探讨。Objective To investigate the clinical features of ocular involvement and the application of Rose criteria in patients with relapsing polychondritis(RP).Methods The data from RP patients with ocular involvement were collected and analyzed.Patients included must have at least one major criteria of Michet criteria and the application Rose criteria was also investigated.Demographic data of these patients was presented as percentages.The difference between types of disease onset was tested by Mann-Whitney U and comparison among groups was tested by False Discovery Rate.Results A total of 192 patients were enrolled 98 males and 94 females.The mean age of disease onset was(42±14)(0.5-79)years old,the median disease duration(DD)was 13(0.5,600)months.The median RP disease activity index(RPDAI)was 39(9-74)and the median RP organ damage index(RPODI)was 2.5(0.1,108).The median RP damage index(RPDAM)was 3(1-6).The statistical significant difference was identified in median DD between groups of nose and pinna(Z=10.775,P<0.01),nose and OEH(Z=9.277,P<0.01),in RPODI between groups of nose and pinna(Z=7.999,P=0.031),nose and and extra-cranial organs(Z=8.115,P=0.030)and eye and airway involvement of RPDAM could be seen between groups(Z=7.683,P=0.037)respectively.Ocular involvement(50.0%),auricular chondritis(21.4%)and airway chondritis(13.5%)were the top three most common symptoms at disease onset.The ocular involvement(100%),airway chondritis(75.0%)and inner ear involvement(69.3%)were the top three most frequent affected organs.All parts of eye could be involved in RP ocular damage.Single-organ involvement was 59.9%;and multi-organ involvement could be seen in 40.1%patients.Diagnostic strength was enhanced by application of Rose criteria in 171 cases fulfilled Michet criteria and 21(10.9%)cases partially fulfilled Michet criteria fulfilled Rose criteria.Active screening for organ(especially inner ear and airway)involvement would improve the rate of early diagnosis.The pinna and airway involvement suggested nose and middle-ear mig

关 键 词：多软骨炎 复发性 眼部损害 诊断 

分 类 号：R681.3[医药卫生—骨科学] R771.3[医药卫生—外科学]