风湿性多肌痛45例临床分析

目的:分析风湿性多肌痛的临床特点及治疗反应,提高对风湿性多肌痛的认识。方法:回顾分析皖南医学院附属弋矶山医院风湿免疫科2007～2011年住院及门诊确诊为风湿性多肌痛的45例患者的临床表现和治疗反应。结果:①女性多见,男女比为1∶5.43,女性发病年龄低于男性,病程长于男性。②临床以累及肩胛带肌和骨盆带肌痛多见,其次为发热和关节痛,乏力及体质量下降相对少见。③所有患者均有血沉(ESR)和C反应蛋白(CRP)升高。轻中度贫血31例(68.89%),免疫球蛋白升高18例(40%),肝功能异常8例(17.78%),血小板异常5例(11.11%)。④41例(91.11%)患者需要泼尼松或泼尼松联合甲氨蝶呤治疗,单纯非甾体抗炎药治疗4例(8.89%)。结论:PMR多见于50岁以上老年患者,以肩胛带及骨盆带肌肉疼痛和晨僵多见,ESR≥50 mm/1 h伴CRP升高,小剂量激素治疗显效。

Clinical analyses of polymyalgia rheumatica in 45 patients

Objective:To analyze the clinical features of polymyalgia rheumatica(PMR) and its response to certain treatment for better understanding of this disorder.Methods:The clinical features and the treatment response were retrospectively analyzed in 45 patients on out-patient treatment basis in our department between 2007 and 2011.Results:①PMR occurred more common in women than men with a ratio of 1∶ 5.43,and it affected younger women and had a longer disease duration as compared with men.② The shoulder girdle muscles and the pelvic girdle myalgia were more affected,followed by fever and joint pain,yet fatigue and weight loss were relatively rare.③ Increased erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) were seen in all patients.Of the total cases,mild to moderate anemia was seen in 31(68.89%),elevated immunoglobulin in 18(40%),abnormal liver function in 8(17.78%),and platelet abnormalities in 5(11.11%).④ Forty-one cases(91.11%)required single medication of prednisone or combined prednisone and methotrexate,and 4(8.89%) were managed with simple non-steroidal anti-inflammatory agent.Conclusion:PMR more common in elderly patients over 50 years with morning stiffness(MST) and the shoulder girdle muscles and the pelvic girdle involvement as well as increased ESR ≥ 50 mm/1 h and elevated CRP.Small dosage of hormone therapy may relieve this disorder.