女性与男性强直性脊柱炎对比研究

目的了解不同性别的强直性脊柱炎的临床特点。方法对比性地分析５７例女性ＡＳ（ＦＡＳ）患者和１１４例病程相同的男性ＡＳ（ＭＡＳ）患者（１∶２配对）的临床表现及实验室检查结果。结果平均发病年龄、首发症状、腰椎的Ｘ线受累和病情活动指标在两组无差异（Ｐ＞０．０５）;贫血、外周关节炎和颈椎的受累在女性明显多于男性（Ｐ＜０．０５）;而全身症状、虹膜睫状体炎、严重的骶髂关节及髋关节的Ｘ线受累和ＨＬＡ－Ｂ２７的阳性率在女性明显少于男性（Ｐ＜０．０５）。结论ＦＡＳ患者病情发展较慢,预后较好。这与Ｂ２７阳性率低至少部分地相关。     

幼年银屑病关节炎

患儿,男,12岁。主因双足跟肿痛1年半,加重伴右膝、踝关节肿痛及活动受限2月,右髋关节痛1周入院。否认银屑病家族史。双手指甲呈“顶针”样凹陷;双足掌跖皮肤有对称性红斑、鳞屑性斑块伴脓疱;指（趾）无“腊肠”样改变。双下肢“4字”试验阴性,右侧浮髌试验（+）。ESR增快,CRP升高类风湿因子（RF）阴性,人类白细胞抗原（HLA -B27）（+）,抗核抗体（ANA）、抗可提取核抗原抗体（ENA）、抗双链DNA抗体（ds-DNA）抗体阴性。双骶髂关节核磁平扫及增强未见异常。双膝、踝关节超声示右膝、踝关节骨皮质侵蚀改变伴积液。皮肤活检病理结果符合银屑病。诊断幼年银屑病关节炎(juvenile psoriatic arthritis,JPsA)。经非甾体抗炎药、柳氮磺吡啶和关节腔注射长效皮质激素治疗后,症状无明显好转,ESR继续增快,故改用来氟米特（Leflunomide）加anti-TNF的生物制剂依那西普（Etanercept）治疗。2周后,患儿症状明显好转,ESR接近正常,CRP阴性,出院后继用来氟米特和依那西普治疗。［中国当代儿科杂志,2007,9（4）：339-342］     

纤维肌痛综合征的药物治疗进展

<正>纤维肌痛综合征(fibromyalgia syndrome,FMS) 是一种主要表现为肌肉骨骼疼痛和发僵,并在特殊部位有压痛点的非关节性风湿病。据统计,美国总共有600万-1000万患者,是仅次于骨性关节炎和类风湿关节炎的常见风湿病。本病也是引起慢性     

雷诺现象在系统性红斑狼疮中的临床意义

雷诺现象(ＲＰ)是指发作性血管痉挛导致的肢体末端皮肤颜色改变及感觉异常的症状。它是结缔组织病(ＣＴＤ)如系统性红斑狼疮(ＳＬＥ)、系统性硬化症等较常见的临床表现。为探讨雷诺现象在ＳＬＥ中的临床意义,我们对近4年在我院住院的42例伴ＲＰ的ＳＬＥ患者进行了分析,并与116例无ＲＰ的ＳＬＥ患者进行对照,现分析如下。1　资料与方法11　病例选择:1995年5月至1999年6月在我院住院的ＳＬＥ患者共158例,其中伴ＲＰ者42例,无ＲＰ者(对照组)116例。12　诊断标准:①所有病例诊断均符合美国风湿病协会1982年关于ＳＬＥ的诊断标准。②ＲＰ诊断根据…     

尿酸持续达标是难治性痛风治疗的关键

正难治性痛风是急性痛风性关节炎反复发作数年后,出现慢性多发性、破坏性关节炎伴痛风石形成和(或)尿酸性肾结石,常规量降尿酸药难以使血尿酸达标的痛风。临床上,难治性痛风患者越来越多见,临床医师易忽视尿酸"持续达标"治疗的重要性。     

系统性红斑狼疮与妊娠

系统性红斑狼疮(SLE)是一种全身性自身免疫病,多发生于育龄期女性。SLE与妊娠之间相互作用,一方面,妊娠期免疫状态及生理变化可导致狼疮复发,另一方面,SLE患者在妊娠过程中疾病复发,发生狼疮肾炎加重、高血压、子痫、胎儿丢失、早产儿及新生儿狼疮等的机率明显升高。尽管风湿免疫科医师对狼疮患者的妊娠较为重视,但母亲和胎儿的死亡率仍居高不下,因此,进一步增进对狼疮与妊娠的认识、选择合适的妊娠时机、应用安全的药物保持病情尤为重要。     

普通感冒如何治疗

季节更替．转眼就到了秋季。这个季节,天气变换剧烈,所以也是感冒的高发季节。长久以来．人们对付感冒各有奇招．但是没有一种方法是放之四海皆有效且正确的。下面我们就请专家给我们说说     

女性风湿病患者避孕方法的选择

较多的弥漫性结缔组织病包括系统性红斑狼疮(systemic lupus erythematosus,SLE)和抗磷脂综合征(antiphosplholipid syndrome,APS)等主要累及育龄期女性,这些患者多因本病活动或正服用免疫抑制剂而不能怀孕,需采取措施避孕,如何安全有效的避孕是近年来的热点问题.     

全国多中心类风湿关节炎患者门诊用药费用的调查

Objective To describe the distribution of medication costs of rheumatoid arthritis patients, and to analyze the factors that may affect the costs. Methods Data were obtained from a 12-month retrospective investigation of patients with rheumatoid arthritis (RA) across China. Department of Rheuma-tology of 18 hospitals were randomly selected. The data about their social conditions, clinical conditions, medications associated with RA such as disease-modifying antirheumatic drugs (DMARDs), non -steroidal anti -inflammtory drugs (NSAIDs), steroids, biologic agents were collected, and the costs of drugs were calculated. A non-parameter test and multivariate logistic regression analysis were performed. Results Six hundred and forty six patients were enrolled into the study, 435 completed data were chosen for analysis. The results demonstrated that the average costs per patient for medications in the past year was 8018 . The total medication costs were further subdivided into the following parts: DMARDs, (represented 20% of the total costs), biologic drugs (49%), NSAIDs (4%), herbal drugs (22%), steroids (1%). Data analysis showed that patients with higher education and higher incomes, with medical insurance,better health function status and outpatients paid more on DMARDs. Extra-articular manifestations increased the odds of the high-cost group (OR: 2.180, 95%CI: 1.335～3.558, P=0.002), while poor health function status increased the probability of paying high costs (OR: 1.373, 95%CI: 1.012～1.863, P=0.041). Conclusion High medication costs in RA do exist in RA patients. The costs of medication is associated with health function status and the presence of extra-articular manifestations.