风湿性多肌痛53例临床的的特点及诊治分析.docVIP

风湿性多肌痛53例临床的的特点及诊治分析 　　[摘要] 目的 探?风湿性多肌痛的临床诊疗特点，提高对风湿性多肌痛的认识，减少误诊与漏诊。 方法 回顾分析2008年9月～2016年9月在内蒙古医科大学附属医院风湿免疫科住院及门诊确诊为风湿性多肌痛53例患者的临床表现和治疗反应。 结果 患者多为女性，男女比为1：2.8，平均发病年龄（66.96±9.51）岁，平均病程（11.80±6.23）个月。临床表现以累及颈后肌、肩胛带肌和骨盆带肌痛多见，其次为多关节疼痛肿胀，晨僵、发热以及体重下降。本资料中女性患者颈肩痛和骨盆带肌痛比例均高于男性患者（P 0.05）。血沉增快者占94.3%，平均为（49.30±25.56）mm/h；C反应蛋白升高者为84.9%，平均为（33.95±24.89）mg/L。轻中度贫血15例（28.3%）。治疗及预后方面，单用泼尼松治疗者为15例（28.3%），泼尼松联合免疫抑制剂治疗者为38例（71.7%）；41例（77.4%）患者病情持续缓解，12例（22.6%）患者病情复发。 结论 风湿性多肌痛患者多见于50岁以上老年女性，以肩胛带和骨盆带肌肉疼痛伴晨僵多见，小剂量激素治疗后有效。 　　[关键词] 风湿性多肌痛；临床表现；诊断标准；治疗方案 　　[中图分类号] R593 [文献标识码] A [文章编号] 1673-7210（2017）03（a）-0049-04 　　Clinical feature， diagnosis and treatment of polymyalgia rheumatica in 53 patients 　　Dagula1 YUAN Rong2 LI Hongbin1 WANG Yong1 　　1.Department of Rheumatology， the Affiliated Hospital of Inner Mongolia Medical University， Inner Mongolia Autonomous Region， Huhhot 010000， China； 2.Department of Record Room， Mongolian Medicine and Traditional Chinese Medicine Hospital of Huhhot ， Inner Mongolia Autonomous Region， Huhhot 010030， China 　　[Abstract] Objective To explore the clinical characteristics of polymyalgia rheumatic （ PMR） and its response to treatment for better understanding of this disease and reduce the missed diagnosis and misdiagnoses. Methods The clinical features and the treatment response in 53 patients from Department of Rheumatology， the Affiliated Hospital of Inner Mongolia Medical University from September 2008 to September 2016 were retrospectively analyzed. Results PMR occurred more common in females. The sex ratio of male to female was 1：2.8， the average age of （66.96±9.51） years； the mean duration of （11.80±6.23） monuths. The shoulder girdle muscles and hip girdle muscles were more affected， followed by joint pain， morning stiffness， fever and weight loss. In this case， the ratio of shoulder girdle and hip pain in female patients is higher than that in male patients （P 　　实验室检查方面，本研究的53例PMR患者中，有94.3%的患者出现ESR增快，84.9%的患者出现CRP升高，在PMR中血沉增快并且≥50 mm/h，是该病