3种不同类型结缔组织病合并股骨头缺血性坏死的临床特点分析  

Clinical Characteristics of Three Different Types of Connective Tissue Disease Complicated by Femoral Head Necrosis

作　　者：洪学志 刘雷 李啸天[2] 姚韵倩 许佳[1] 莫汉有[1] HONG Xue-zhi;LIU Lei;LI Xiao-tian;YAO Yun-qian;XU Jia;MO Han-you(Department of Rheumatology,Affiliated Hospital of Guilin Medical College,Guilin 541000,China;Department of Imaging,Affiliated Hospital of Guilin Medical College,Guilin 541000,China)

机构地区：[1]桂林医学院附属医院风湿免疫科,广西桂林541000 [2]桂林医学院附属医院影像科,广西桂林541000

出　　处：《实用临床医学（江西）》2022年第3期1-3,27,共4页Practical Clinical Medicine

基　　金：国家自然科学基金(81760298);广西自然科学基金(2020GXNSFBA297149)。

摘　　要：目的分析3种不同类型结缔组织病(CTD)伴发股骨头缺血性坏死(ANFH)的临床特点。方法选取桂林医学院附属医院2014年2月至2021年7月收治的CTD合并ANFH患者40例,按疾病类型不同分为3组:类风湿关节炎(RA)组21例、系统性红斑狼疮(SLE)组10例及强直性脊柱炎(AS)组9例,比较3组发病年龄、激素使用率及临床症状(双侧骨坏死、髋关节疼痛、骨质疏松、肾功能损害、贫血、高脂血症及雷诺/口腔溃疡)。结果与SLE组及RA组比较,AS组发病平均年龄明显降低(P<0.05);与RA组及AS组比较,SLE组激素使用率、出现肾功能损害及雷诺/口腔溃疡的百分率均明显升高(均P<0.05),3组双侧骨坏死、髋关节疼痛、骨质疏松、贫血及高脂血症等临床症状的发生率比较,差异无统计学意义(P>0.05)。结论在伴发ANFH的3种不同类型CTD疾病中,AS发生ANFH的平均年龄最小,SLE患者激素使用率、肾功能损害及雷诺/口腔溃疡的发生率最高。对于使用激素及合并多种危险因素的CTD患者,临床医生需警惕ANFH发生,应早期筛查。Objective To analyze the clinical characteristics of connective tissue disease(CTD)complicated by avascular necrosis of the femoral head(ANFH).Methods A total of 40 patients with CTD and ANFH admitted to the Affiliated Hospital of Guilin Medical College from February 2014 to July 2021 were divided into three groups:21 cases of rheumatoid arthritis(RA),10 cases of systemic lupus erythematosus(SLE),and 9 cases of ankylosing spondylitis(AS).The age of onset,hormone use rate,and clinical symptoms(bilateral osteonecrosis,hip joint pain,osteoporosis,renal impairment,anemia,hyperlipidemia and Raynaud’s/oral ulcer)were compared among the three groups.Results The average age of onset in AS group was younger than that in SLE or RA group(P<0.05).The rate of hormone use and the incidence of renal impairment and Raynaud’s/oral ulcer in SLE group were higher than those in RA or AS group(P<0.05).There were no statistical differences in the incidence of bilateral osteonecrosis,hip joint pain,osteoporosis,anemia and hyperlipidemia between SLE group and RA or AS group(P>0.05).Conclusion Among the three types of CTD complicated by ANFH,the average age of ANFH onset is youngest in AS patients,and the rate of hormone use and the incidence of renal impairment and Raynaud’s/oral ulcer are highest in SLE patients.For CTD patients with hormone use and multiple risk factors,the occurrence of ANFH should be attended to and early screening should be carried out.

关 键 词：结缔组织病 股骨头缺血性坏死 临床特点 激素 发病年龄 

分 类 号：R593.2[医药卫生—内科学]