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1、第30卷第1期同济大学学报(医学版)Vol.30No.12009年2月JOURNALOFTONGJIUNIVERSITY(MEDICALSCIENCE)Feb.,2009·临床研究·成人Still病临床分析龚益,殷少军,颜正茂,张国良(同济大学附属第十人民医院呼吸内科,上海200072)【摘要】目的探讨成人Still病的临床特点。方法回顾性分析第十人民医院呼吸科1985～2008年间确诊的资料完整的23例成人Still病患者的临床资料。结果临床表现为发热23例,皮疹20例,四肢肌肉关节酸痛17例,以及咽痛,淋巴结肿大,肝脾肿大,尿蛋白,尿隐血等
2、。实验室检查:白细胞总数均高于正常,贫血20例,C反应蛋白均升高,类风湿因子多数阴性。血清谷丙谷草转氨酶升高13例,全部患者多次血培养均阴性。15例患者作了骨髓穿刺,均为感染性骨髓象,骨髓细菌培养阴性。治疗上首选糖皮质类固醇激素和非甾体类消炎药,酌情加用免疫抑制剂,23例患者均获得缓解,疗程2周～4个月不等,其中2例患者分别在1年及16年后症状复发,再次使用激素后症状缓解。结论成人Still病临床表现复杂,容易误诊,多数预后较好,但可能复发加重,应加强随访。【关键词】成人Still病;诊断;治疗【中图分类号】R758【文献标识码】A【文章编号】
3、1008-0392(2009)01-0135-04ClinicalanalysisofStill’sdiseaseinadultGONGYi,YINShao2jun,YANZheng2mao,ZHANGGuo2liang(Dept.ofRespiratory,TenthPeople’sHospital,TongjiUniversity,Shanghai200072,China)【Abstract】ObjectiveTostudytheclinicalcharacteristicsofadultonsetStill’sdisease(AOSD).
4、MethodsTwenty2threecaseswithAOSDinTenthPeople’sHospitalwerecollectedfrom1985—2008,andtheirclinicalmanifestationsandlaboratorytestswereanalyzedretrospectively.ResultsAll23caseshadfever,20caseshadrash,17caseshadarthralgia.Somesymptomssuchaspharyngalgia,enlargementoflymphnode,h
5、epatosplenomegalywerepresentedinsomepatients.Bylaboratorytest,thenumberofwhitebloodcell(WBC)andthelevelofCreactiveprotein(CRP)increasedinall23patients.Twentypatientshadanaemia.13patientsamong23gotaraiseofalanineaminotransferase(ALT)oraspartateaminotransferase(AST).Fifteencas
6、eshadbonemarrowaspirationshowinginfectivitywhilebacterialcultureswerenegative.Glucocorticoidandnon2steroidalanti2inflammatorydrug(NSAID)werethefirstchoicefortreatmentcombinedwithimmunodepressantifpossible.Symptomsinall23patientsreleasedaftertreatmentfor2weekstofourmonths.Two
7、patientsre2occurredin1yearand16yearslaterrespectively,andreleasedafterglucocorticoidtreatment.ConclusionAdult2onsetStill’sdiseaseisadiseasewithvariedmanifestations,itiseasytobemisdiagnosed.Mostpatientshavefavorableprognosis,butsomeofthemwillrecur.Itisnecessarytofollowitinten
8、sely.收稿日期:2008-04-21作者简介:龚益(1978-),女,住院医师,硕士.E2mail:hallengong@sina.com通讯作者
