43例复发性多软骨炎耳部表现并文献复习

目的 总结43 例复发性多软骨炎(relapsing polychondritis,RP) 患者临床特征并与国内外资料比较,提高对该病的认识.方法 结合文献回顾43 例RP 临床资料,重点分析RP 耳部表现及治疗.结果 43 例患者男女发病比例1.5∶1,平均发病年龄40.3(13-72) 岁,平均病程15 个月.以耳部表现起病者17 例(39.5%),病程中累及耳部的38 例(88.4%),其中耳廓软骨炎33 例(76.7%)、咽鼓管功能障碍3 例(7%)、外耳炎6 例(14%)、眩晕4 例(9.3%)、耳鸣12 例(28%)、感音性听觉丧失7 例(16.3%).所有患者均接受糖皮质激素治疗,37 例联合其他免疫抑制剂治疗,出院之前症状均有明显缓解.结论 RP 主要依靠临床症状诊断,实验室及病理学检查对诊断有辅助作用.对于耳部病变者,耳科医师与风湿科医师共同诊治,有助于早期诊断和治疗.

Otological manifestations of relapsing polychondritis: A report of 43 cases and review of the literatures

Objective To summarize the clinical features of 43 patients with relapsing polychondritis(RP) in order to have a better understanding of it.Methods Clinical data about 43 RP patients were retrospectively analyzed with stress laid its otological manifestations and treatment.Results The male and female ratio was 1.5∶1.The average age of patients at onset of RP was 40.3 years(range 13-72).The average course of RP was 15 months.The otological manifestations were observed in 17(39.5%) out of the 44 patients with the ear involved in 38 patients(88.4%).Auricular chondritis,eustachian tube dysfunction,otitis externa,vertigo,tinnitus and sensorineural hearing loss were diagnosed in 33(76.7%),3(7%),6(14%),4(9.3%),12(28%),and 7 patients(16.3%),respectively.All patients were treated with corticosteroids and 37 out of them were treated with combined corticosteroids and other immunosuppressive inhibitors.Their symptoms were significantly improved before they were discharged.Conclusion The diagnosis of RP mainly depends on its clinical manifestations plus laboratory tests and pathological examinations.Otologists in combination with rheumatologists contribute to the early diagnosis and treatment of RP involving the ear.