临床荟萃
臨床薈萃
림상회췌
CLINICAL FOCUS
2015年
5期
548-551
,共4页
关节炎,类风湿%干燥综合征%病理状态,体征和症状
關節炎,類風濕%榦燥綜閤徵%病理狀態,體徵和癥狀
관절염,류풍습%간조종합정%병리상태,체정화증상
arthritis,rheumatoid%sjogren’s syndrome%pathological conditions,signs and symptoms
目的：探讨类风湿关节炎(RA)合并干燥综合征(SS)患者的临床及实验室特征,并与原发性干燥综合征(pSS)及单纯 RA 患者进行比较,了解 RA 合并 SS 患者的临床及血清学特点。方法随机入选单纯 RA 患者124例,同时参照 SS 诊断标准选取47例 RA-SS 患者及68例 pSS 患者进行比较。结果在47例 RA-SS 患者中24例(51.1%)患者的 SS 发生于 RA 之后,4例(8.5%)患者的 SS 发生于 RA 之前,19例(40.4%)患者为两病同时出现。与单纯 RA 组患者比较,RA-SS 组患者 RA 发病年龄小,晨僵发生率低,乏力、口干眼干发生率高,抗核抗体(ANA)、抗干燥综合征 A(SSA)抗体、抗干燥综合征 B(SSB)抗体、IgG 升高、C4降低及球蛋白升高的阳性率高,而 C 反应蛋白(CRP)升高的阳性率低,肺部病变及白细胞减少发生率高。与 pSS 组患者比较,RA-SS 组患者病程长,受累关节数多,晨僵及畸形发生率高,乏力、眼干及口干的发生率低,ANA、抗 SSA、抗 SSB 抗体阳性率低,而 RF、抗 CCP 抗体、CRP 及血沉(ESR)升高的阳性率高,肺部病变及贫血发生率高,白细胞减少发生率低。结论 RA-SS 在临床并不少见,具有与单纯的 RA 及 pSS 不同的临床及实验室特征。
目的：探討類風濕關節炎(RA)閤併榦燥綜閤徵(SS)患者的臨床及實驗室特徵,併與原髮性榦燥綜閤徵(pSS)及單純 RA 患者進行比較,瞭解 RA 閤併 SS 患者的臨床及血清學特點。方法隨機入選單純 RA 患者124例,同時參照 SS 診斷標準選取47例 RA-SS 患者及68例 pSS 患者進行比較。結果在47例 RA-SS 患者中24例(51.1%)患者的 SS 髮生于 RA 之後,4例(8.5%)患者的 SS 髮生于 RA 之前,19例(40.4%)患者為兩病同時齣現。與單純 RA 組患者比較,RA-SS 組患者 RA 髮病年齡小,晨僵髮生率低,乏力、口榦眼榦髮生率高,抗覈抗體(ANA)、抗榦燥綜閤徵 A(SSA)抗體、抗榦燥綜閤徵 B(SSB)抗體、IgG 升高、C4降低及毬蛋白升高的暘性率高,而 C 反應蛋白(CRP)升高的暘性率低,肺部病變及白細胞減少髮生率高。與 pSS 組患者比較,RA-SS 組患者病程長,受纍關節數多,晨僵及畸形髮生率高,乏力、眼榦及口榦的髮生率低,ANA、抗 SSA、抗 SSB 抗體暘性率低,而 RF、抗 CCP 抗體、CRP 及血沉(ESR)升高的暘性率高,肺部病變及貧血髮生率高,白細胞減少髮生率低。結論 RA-SS 在臨床併不少見,具有與單純的 RA 及 pSS 不同的臨床及實驗室特徵。
목적：탐토류풍습관절염(RA)합병간조종합정(SS)환자적림상급실험실특정,병여원발성간조종합정(pSS)급단순 RA 환자진행비교,료해 RA 합병 SS 환자적림상급혈청학특점。방법수궤입선단순 RA 환자124례,동시삼조 SS 진단표준선취47례 RA-SS 환자급68례 pSS 환자진행비교。결과재47례 RA-SS 환자중24례(51.1%)환자적 SS 발생우 RA 지후,4례(8.5%)환자적 SS 발생우 RA 지전,19례(40.4%)환자위량병동시출현。여단순 RA 조환자비교,RA-SS 조환자 RA 발병년령소,신강발생솔저,핍력、구간안간발생솔고,항핵항체(ANA)、항간조종합정 A(SSA)항체、항간조종합정 B(SSB)항체、IgG 승고、C4강저급구단백승고적양성솔고,이 C 반응단백(CRP)승고적양성솔저,폐부병변급백세포감소발생솔고。여 pSS 조환자비교,RA-SS 조환자병정장,수루관절수다,신강급기형발생솔고,핍력、안간급구간적발생솔저,ANA、항 SSA、항 SSB 항체양성솔저,이 RF、항 CCP 항체、CRP 급혈침(ESR)승고적양성솔고,폐부병변급빈혈발생솔고,백세포감소발생솔저。결론 RA-SS 재림상병불소견,구유여단순적 RA 급 pSS 불동적림상급실험실특정。
Objective To investigate the clinical and serologic features of rheumatoid arthritis (RA)in patients with Sjogren syndrome (SS)in comparison with primary Sjogren syndrome (pSS)and rheumatoid arthritis (RA). Methods Forty-seven RA patients with SS (RA-SS),124 RA patients without SS and 68 pSS were enrolled in this study,and clinical and laboratory parameters were observed.Results Among patients with RA-SS,there were 24 cases (5 1.1%)RA-onset SS,4 cases (8.5%)SS-onset RA and 14 (40.4%)cases with simultaneous-onset RA and SS.Compared with RA without SS,the patients with RA-SS were younger and showed a higher incidence of weakness, xerostomia,xerophthalmia,leucopenia and lung involvement,a higher positive rate of ANAs,anti-SSA and anti-SSB antibodies,higher IgG and lower C4 and a lower positive rate of higher CRP.Compared with the pSS patients group, RA-SS patients had a longer disease duration,more severe arthritis,a higher incidence of morning stiffness,deformed joints anemia and lung involvement,a higher positive rate of RF,anti-CCP antibodies,higher level CRP and ESR,a lower incidence of weakness,xerostomia,xerophthalmia and leucopenia,a lower positive rate of ANAs,anti-SSA and anti-SSB antibodies.Conclusion RA-SS patients have distinct clinical and laboratory features which differed from those of RA or pSS patients.
