中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2015年
21期
2607-2610
,共4页
红斑狼疮, 系统性%关节炎, 类风湿%Rhupus综合征%重叠综合征
紅斑狼瘡, 繫統性%關節炎, 類風濕%Rhupus綜閤徵%重疊綜閤徵
홍반랑창, 계통성%관절염, 류풍습%Rhupus종합정%중첩종합정
Lupus erythematosus,systemic%Arthritis,rheumatoid%Rhupus syndrome%Overlap syndrome
目的：总结类风湿关节炎（ RA）与系统性红斑狼疮（ SLE）重叠的Rhupus综合征的临床特点，提高临床医师对本病的认识。方法回顾性分析株洲市中心医院收治的3例重症Rhupus综合征患者的临床特点、诊治经过，并检索国内外文献进行总结。结果3例患者均为中年女性，均以关节炎起病，经过长病程出现SLE特征性表现，除侵蚀性关节炎外，还有严重脏器受累，表现为急性横贯性脊髓炎、重度溶血性贫血、大量心包积液及肾病综合征，均有多种RA及SLE特异性抗体阳性，经过大剂量激素或激素冲击，并联合环磷酰胺等免疫抑制剂治疗，病情明显改善。结论 Rhupus综合征少见，常以RA起病，关节损害严重，脏器受累一般较轻，但需提高警惕Rhupus综合征也可出现重要脏器受累，及时恰当的诊治对改善预后至关重要。
目的：總結類風濕關節炎（ RA）與繫統性紅斑狼瘡（ SLE）重疊的Rhupus綜閤徵的臨床特點，提高臨床醫師對本病的認識。方法迴顧性分析株洲市中心醫院收治的3例重癥Rhupus綜閤徵患者的臨床特點、診治經過，併檢索國內外文獻進行總結。結果3例患者均為中年女性，均以關節炎起病，經過長病程齣現SLE特徵性錶現，除侵蝕性關節炎外，還有嚴重髒器受纍，錶現為急性橫貫性脊髓炎、重度溶血性貧血、大量心包積液及腎病綜閤徵，均有多種RA及SLE特異性抗體暘性，經過大劑量激素或激素遲擊，併聯閤環燐酰胺等免疫抑製劑治療，病情明顯改善。結論 Rhupus綜閤徵少見，常以RA起病，關節損害嚴重，髒器受纍一般較輕，但需提高警惕Rhupus綜閤徵也可齣現重要髒器受纍，及時恰噹的診治對改善預後至關重要。
목적：총결류풍습관절염（ RA）여계통성홍반랑창（ SLE）중첩적Rhupus종합정적림상특점，제고림상의사대본병적인식。방법회고성분석주주시중심의원수치적3례중증Rhupus종합정환자적림상특점、진치경과，병검색국내외문헌진행총결。결과3례환자균위중년녀성，균이관절염기병，경과장병정출현SLE특정성표현，제침식성관절염외，환유엄중장기수루，표현위급성횡관성척수염、중도용혈성빈혈、대량심포적액급신병종합정，균유다충RA급SLE특이성항체양성，경과대제량격소혹격소충격，병연합배린선알등면역억제제치료，병정명현개선。결론 Rhupus종합정소견，상이RA기병，관절손해엄중，장기수루일반교경，단수제고경척Rhupus종합정야가출현중요장기수루，급시흡당적진치대개선예후지관중요。
Objective The Rhupus syndrome has RA symptom and SLE symptom simultaneously.In order to improve the understanding of this disease among clinicians, the clinical features of Rhupus syndrome are summarized.Methods The clinical features, diagnosis and treatment of 3 patients with severe Rhupus syndrome were analyzed retrospectively, and related literatures at home and abroad were reviewed and summarized.Results 3 patients were middle -aged females, the initial manifestation was arthritis.Characteristic symptoms of SLE manifested after a long course, such as erosive osteoarthritis and serious organ involvement ( acute transverse myelitis, severe autoimmune hemolytic anemia, a large amount of pericardial effusion and nephrotic syndrome ) , many RA -specific and SLE -specific antibodies were positive, the clinical signs and symptoms improved significantly after high -dose corticosteroids or methylprednisolone pulse therapy combined with immunosuppressant ( such as cyclophosphamide) treatment.Conclusion Rhupus syndrome is relatively rare in clinic, the initial manifestation is often symptom of RA, joint damage is severe, but organ involvement is usually relatively light, but vital organs may be involved, which should evoke clinicians′vigilance.Timely and correct diagnosis and treatment is essential to prognosis improvement.
