大连医科大学学报
大連醫科大學學報
대련의과대학학보
Journal of Dalian Medical University
2015年
5期
500-501,520
,共3页
SAPHO综合征%临床表现%影像学%诊断
SAPHO綜閤徵%臨床錶現%影像學%診斷
SAPHO종합정%림상표현%영상학%진단
SAPHO syndrome%clinical manifestation%imaging%diagnosis
目的：了解SAPHO综合征的临床特征，尽早对该病做出诊断。方法收集5例SAPHO综合征患者的血常规（ routine blood tes），肝肾功，血沉，C反应蛋白及免疫球蛋白，补体，HLA－B27等相关化验检查及胸锁关节、骶髂关节及腰椎CT，全身骨扫描检查临床资料。5例均有不同程度的皮肤、骨改变，其中2例有骶髂关节受累，1例耻骨联合受累，1例脊柱受累，3例有外周关节受累。4例HLA－B27阴性，1例阳性。5例患者分别予非甾体抗炎药，糖皮质激素及免疫抑制剂，肿瘤坏死因子拮抗剂，中药治疗。结果1例应用类克治疗，症状很快得到改善。3例分别在激素，NSAIDS基础上联合雷公藤，甲氨蝶呤，柳氮磺吡啶治疗，1例应用中药治疗，临床上关节肿痛好转。结论本病好发于中年女性，以掌跖脓疱病及上胸壁、胸锁关节受累多见，若无典型皮肤改变，容易误诊，影像学检查是必要的。早期进行治疗可以有效减轻症状，干预疾病进展。
目的：瞭解SAPHO綜閤徵的臨床特徵，儘早對該病做齣診斷。方法收集5例SAPHO綜閤徵患者的血常規（ routine blood tes），肝腎功，血沉，C反應蛋白及免疫毬蛋白，補體，HLA－B27等相關化驗檢查及胸鎖關節、骶髂關節及腰椎CT，全身骨掃描檢查臨床資料。5例均有不同程度的皮膚、骨改變，其中2例有骶髂關節受纍，1例恥骨聯閤受纍，1例脊柱受纍，3例有外週關節受纍。4例HLA－B27陰性，1例暘性。5例患者分彆予非甾體抗炎藥，糖皮質激素及免疫抑製劑，腫瘤壞死因子拮抗劑，中藥治療。結果1例應用類剋治療，癥狀很快得到改善。3例分彆在激素，NSAIDS基礎上聯閤雷公籐，甲氨蝶呤，柳氮磺吡啶治療，1例應用中藥治療，臨床上關節腫痛好轉。結論本病好髮于中年女性，以掌蹠膿皰病及上胸壁、胸鎖關節受纍多見，若無典型皮膚改變，容易誤診，影像學檢查是必要的。早期進行治療可以有效減輕癥狀，榦預疾病進展。
목적：료해SAPHO종합정적림상특정，진조대해병주출진단。방법수집5례SAPHO종합정환자적혈상규（ routine blood tes），간신공，혈침，C반응단백급면역구단백，보체，HLA－B27등상관화험검사급흉쇄관절、저가관절급요추CT，전신골소묘검사림상자료。5례균유불동정도적피부、골개변，기중2례유저가관절수루，1례치골연합수루，1례척주수루，3례유외주관절수루。4례HLA－B27음성，1례양성。5례환자분별여비치체항염약，당피질격소급면역억제제，종류배사인자길항제，중약치료。결과1례응용류극치료，증상흔쾌득도개선。3례분별재격소，NSAIDS기출상연합뢰공등，갑안접령，류담광필정치료，1례응용중약치료，림상상관절종통호전。결론본병호발우중년녀성，이장척농포병급상흉벽、흉쇄관절수루다견，약무전형피부개변，용역오진，영상학검사시필요적。조기진행치료가이유효감경증상，간예질병진전。
Objective To investigate the clinical characteristics of SAPHO syndrome and to improve the recognition of the disease.Methods The 5 patients of SAPHO syndrome were tested for routine peripheral blood, liver function, renal func-tion, erythrocyte sedimentation rate ( ESR) , c reactive protein ( CRP) , immunoglobulin, complement and human leucocyte antiget-B27 (HLA-B27) et al, and received sternoclavicular joint CT, sacroiliac joint CT, lumbar vertebra bone scan. The patients were given non-steroidal anti -inflammatory drug ( NSAID ) , glucocorticoids, tumor necrosis factor -α( TNF-α) and chinese medicine.Results Clinical manifestations included skin, joints and bones.Sacroiliac joints were involved in 2 patients, including pubic symphysis and spine in 1 patient each.Peripheral joints were involved in 3 patients. One patient was positive for HLA-B27;whereas the other four were negative.One patient received etanercept;3 patients were given NSAIDS and glycocorticosteroid plus methotrexate, sulfalazine, or Glucosidorum Tripterygll Totorum; one pa-tient was given chinese medicine.All of the treatments had a good effect.Conclusion Females are dominant in our cases. Palmoplantar pustulosis and anterior chest wall, sternoclavicular joint are the most common manifestations.It is easy to be misdiagnosed if the patient does not have typical skin symptoms.Early treatment can reduce clinical symptoms and slow the progression.
