中华全科医师杂志
中華全科醫師雜誌
중화전과의사잡지
CHINESE JOURNAL OF GENERAL PRACTITIONERS
2010年
10期
687-690
,共4页
盖宁宁%谷伟军%窦京涛%巴建明%吕朝晖%杨国庆%杜锦%郭清华%王先令%母义明%陆菊明
蓋寧寧%穀偉軍%竇京濤%巴建明%呂朝暉%楊國慶%杜錦%郭清華%王先令%母義明%陸菊明
개저저%곡위군%두경도%파건명%려조휘%양국경%두금%곽청화%왕선령%모의명%륙국명
自身免疫疾病%肾小管酸中毒%干燥综合征
自身免疫疾病%腎小管痠中毒%榦燥綜閤徵
자신면역질병%신소관산중독%간조종합정
Autoimmunity disease%Renal tubular acidosis%Sjogen's syndrome
目的 探讨肾小管酸中毒(RTA)合并与未合并自身免疫性疾病患者的临床表现及免疫学特点.方法 回顾性分析1999-2009年收治的60例合并自身免疫性疾病与40例未合并自身免疫性疾病RTA患者的临床表现、免疫学检查及肾小管功能等资料.结果 合并自身免疫性疾病患者共60例,59例为Ⅰ型RTA,1例为Ⅱ型RTA,合并的自身免疫性疾病主要为干燥综合征,55例(92%);最常见的临床表现为无力软瘫(50例,83%)、多饮多尿(28例,47%)、关节痛(28例,47%)和骨病变(24例,40%).与不合并自身免疫性疾病的40例RTA患者相比,骨病变(40%与20%)及关节痛(47%与22%)的发生率增高(均P＜0.01),甲状旁腺激素水平均显著升高(P＜0.05);抗核抗体(ANA)、抗SSA抗体、抗SSB抗体阳性率分别为88%(49/56)、84%(47/56)和43%(24/56),均高于未合并自身免疫性疾病者(均P＜0.05).结论 RTA合并的自身免疫性疾病中,干燥综合征最为多见,骨病变及关节痛发生率高于未合并自身免疫性疾病患者;对有相关症状的患者尽早完成相关检查,以利早期诊断和治疗.
目的 探討腎小管痠中毒(RTA)閤併與未閤併自身免疫性疾病患者的臨床錶現及免疫學特點.方法 迴顧性分析1999-2009年收治的60例閤併自身免疫性疾病與40例未閤併自身免疫性疾病RTA患者的臨床錶現、免疫學檢查及腎小管功能等資料.結果 閤併自身免疫性疾病患者共60例,59例為Ⅰ型RTA,1例為Ⅱ型RTA,閤併的自身免疫性疾病主要為榦燥綜閤徵,55例(92%);最常見的臨床錶現為無力軟癱(50例,83%)、多飲多尿(28例,47%)、關節痛(28例,47%)和骨病變(24例,40%).與不閤併自身免疫性疾病的40例RTA患者相比,骨病變(40%與20%)及關節痛(47%與22%)的髮生率增高(均P＜0.01),甲狀徬腺激素水平均顯著升高(P＜0.05);抗覈抗體(ANA)、抗SSA抗體、抗SSB抗體暘性率分彆為88%(49/56)、84%(47/56)和43%(24/56),均高于未閤併自身免疫性疾病者(均P＜0.05).結論 RTA閤併的自身免疫性疾病中,榦燥綜閤徵最為多見,骨病變及關節痛髮生率高于未閤併自身免疫性疾病患者;對有相關癥狀的患者儘早完成相關檢查,以利早期診斷和治療.
목적 탐토신소관산중독(RTA)합병여미합병자신면역성질병환자적림상표현급면역학특점.방법 회고성분석1999-2009년수치적60례합병자신면역성질병여40례미합병자신면역성질병RTA환자적림상표현、면역학검사급신소관공능등자료.결과 합병자신면역성질병환자공60례,59례위Ⅰ형RTA,1례위Ⅱ형RTA,합병적자신면역성질병주요위간조종합정,55례(92%);최상견적림상표현위무력연탄(50례,83%)、다음다뇨(28례,47%)、관절통(28례,47%)화골병변(24례,40%).여불합병자신면역성질병적40례RTA환자상비,골병변(40%여20%)급관절통(47%여22%)적발생솔증고(균P＜0.01),갑상방선격소수평균현저승고(P＜0.05);항핵항체(ANA)、항SSA항체、항SSB항체양성솔분별위88%(49/56)、84%(47/56)화43%(24/56),균고우미합병자신면역성질병자(균P＜0.05).결론 RTA합병적자신면역성질병중,간조종합정최위다견,골병변급관절통발생솔고우미합병자신면역성질병환자;대유상관증상적환자진조완성상관검사,이리조기진단화치료.
Objective To study clinical and immunological features of renal tubular acidosis (RTA) patients complicated with autoimmunity disease. Methods Data of 60 patients of RTA complicated with autoimmune disease and 40 without it during 1999 and 2009 were reviewed, including clinical features,immunological examinations and renal tubular function. Results Among 60 patients of RTA, 59 were type Ⅰ, one type Ⅱ, and 55 complicated with Sjogen's syndrome (92%), one with systemic lupus erythematosus, nine with autoimmune thyroid disease, and one with rheumatoid arthritis. Flaccid paralysis was manifested in 50 (83%) RTA patients complicated with autoimmune disease, polyuria in 28 (47%),polydipsia in 28 (47%) , bone disorder in 24 (40%) and arthralgia in 28 (47%) cases, but of those without autoimmune disease, bone disease only in eight (20%) and arthralgia in nine (22%) cases, with statistically significant difference ( P ＜0. 01 ). Serum level of parathyroid hormone increased noticeably, with prevalence of positive antinuclear antibody, anti-SSA antibody and anti-SSB antibody of 88 % (49/56),84% (47/56) and 43% (24/56), respectively in RTA patients with autoimmune disease, all significantly higher than those in the patients without it ( P ＜ 0. 05 ). Conclusions Sjogen' s syndrome is the most common and prevalence of bone disorder and arthralgia are significantly higher in patients of RTA complicated with autoimmune disease, which should be examined as early as possible for timely diagnosis and treatment.
