成人still's病59例临床分析

目的探讨成人斯蒂尔氏病(AOSD)的临床特点、伴随症状和误诊原因,以提高对本病的认识和诊断水平.方法回顾性分析59例经临床和实验室确诊的成人斯蒂尔氏病患者的临床表现和实验室检查结果.结果59例患者中发热100%、皮疹78%、关节炎和关节疼痛74%、WBC升高95%、ESR增快91%.有32例患者测定血清铁蛋白,26例升高(81%),病情好转后均明显下降(P<0.01).结论发热、皮疹和关节/关节疼痛是AOSD的主要临床特点,若有WBC升高则诊断AOSD的敏感性和特异性明显增高,血清铁蛋白可作为疾病活动的指标.

Clinical analysis of 59 adult onset still''''s disease

Objective To investigate the clinical characteristic,accompanying symptoms and misdiagnostic reasons of Adult onset still's disease(AOSD) in order to improve physician's level of recognization and diagnosis on it.Methods The clinical manifestations and laboratory examinations of 59 AOSD patients with AOSD were analyzed and summarized in clinical view of point with reviewing articles.Results There are fever 100%,rash 78%,arthritis/arthralgia 74%,leukocytosis 95%,ESR 91%.We inspected serum ferritin in 32 patients and found that serum ferritin increased in 26 patients(81%),with the improvement of the patients' condition,the serum ferritin decreased remarkably( P <0.01).Conclusion fever,rash and arthritis/arthralgia are main clinical characteristics of AOSD,Sensitivity and Specificity are improved remarkably,if we add leukocytosis.Serum ferritin can be as an index of activity of disease.