复发性多软骨炎22例临床研究.docVIP

复发性多软骨炎22例临床研究[摘要] 目的:提高对复发性多软骨炎的认识。方法:回顾性分析22例复发性多软骨炎患者的临床资料。结果:呼吸道受累15例(68%)、眼部受累15例(68%)、耳软骨炎14例(64%)、关节炎/关节痛共11例(50%)、鼻软骨炎10例(45%)、内耳受累9例(41%)、皮肤受累5例(23%)。实验室检查无特异性。呼吸道受累者喉镜检查可见声带水肿、喉管狭窄,支气管镜检查可见气管狭窄和软骨消失等表现。所有患者均接受糖皮质激素及免疫抑制剂治疗。10例呼吸道受累者自发病开始一直未完全缓解,其中3例接受气管切开术,2例接受气管内支架治疗。结论:复发性多软骨炎临床表现多样,易误诊,呼吸道受累比例高且预后差,糖皮质激素联合免疫抑制剂治疗有效,有呼吸道狭窄及塌陷者需辅以手术或介入治疗。? [关键词] 复发性多发性软骨炎; 回顾性研究; 临床表现; 诊断; 治疗? [中图分类号] R593.2; R453; R61[文献标识码] A[文章编号] 1671-7562(2010)01-0053-04? doi:10.3969/j.issn.1671-7562.2010.01.015 Clinical analysis of 22 patients with relapsing polychondritis GENG Jie?1, YE Shuang?2, BAO Chun-de?2 (1. Department of Rheumatology, Jiangsu Provincial Hospital of Integrated Traditional and Western Medicine, Nanjing 210028, China; 2. Department of Rheumatology, Renji Hospital in Shanghai, Shanghai 200001, China) [Abstract] Objective: To enhance the understanding of relapsing polychondritis(RP). Methods: The clinical manifestations, diagnosis, and treatment of 22 patients with RP were retrospectively analyzed. Results: Sites involved included airway in 15 patients(68%), eyes in 15(68%), ear cartilages in 14(64%), joints in 11(50%), nasal cartilages in 10(45%), and inner ears in 9(41%), skin in 5(23%). Laboratory examination had no specificity. Laryngoscopy revealed vocal fold edema and laryngeal stenosis. Bronchoscopy showed stenosis of trachea and both main bronchi and destruction of tracheobronchial cartilage.All patients received corticosteroids and immunosuppressive drugs. 10 patients whose condition never inproved after regular therapy all had airway involvement.Among of them, 3 patients received tracheotomy and 2 patients received metallic stents for their tracheobronchial stenosis. Conclusions: The clinical manifestation in patients with RP is diversity and tendes to be misdiagnosed. Prevalence of airway involvement is not so low with a poor prognosis in patients with RP. Corticosteroids and immunosuppressive drugs are effective on RP. Patients wi