成人Still病20例临床研究

目的:提高对成人Still病的认识。方法:对我院1996年6月～2003年6月确诊的20例成人Still病患者的临床特征、治疗以及预后进行回顾性分析。结果:发热、皮疹、关节痛的发生率分别为100%、75%、90%。白细胞升高及血沉加快的发生率分别为85%、90%,全部病例多次血培养均阴性。12例患者(60%)确诊前被误诊。糖皮质激素对成人Still病的疗效好,部分患者需同时加用免疫抑制剂。讨论:成人Still病临床上以高热、皮疹、关节病变、血白细胞升高、血沉增快、血培养阴性为主要特征。早期诊断并给予糖皮质激素治疗有效,部分患者尚须加用免疫抑制剂。

A clinical analysis of 20 cases adult Still''''s disease

Objective To enhance the understanding of adult onset Still's disease (AOSD). Method Clinical features, laboratory data, treatment, and prognosis of AOSD in 20 patients were analyzed retrospectively. Results Of patients, the percentage of fever, rash, arthralgia, higher WBC, and increased erythrocyte sedimentation rate (ESR) was 100%, 75%, 90%, 85%, and 90% respectively. Blood culture was negative in all the patients. 12 cases were misdiagnosed previously. Treatment with glucocorticoid was effective in the majority of patients and immunosuppressive agents needed to prescribe for the minority of patients. Conclusion The manifestations of AOSD are mainly fever, rash, arthralgia, higher WBC, increased ESR, and negative blood culture. Early diagnosis and treatment with glucocorticoid and immunosuppressive agents can improve the prognosis obviously.