成人Still病24例分析

目的：通过回顾性分析，进一步探讨、研究成人Still病的病因、临床表现、诊断、治疗及预后。方法：回顾性分析1993～22001年经我院临床诊治成人Still病住院患24例。结果：误诊18例，误诊时间最短28d，最长13个月，平均85d；绝大多数患对消炎痛和糖皮质激素反应良好。14例随访中，痊愈6例，复发8例。其中合并噬血细胞综合征误诊为MH1例，死亡2例。结论：成人Still病病因仍不清，可能与感染、免疫反应和类风湿关节炎有关，以发热、皮疹、关节症状为主症，误诊率高，主要靠排除诊断，对非甾体类消炎药和皮质激素治疗反应良好，主要死因为感染和激素副作用。

A Clinical Analysis of 24 Cases of Adult Still''''s Diseases

Objective: To investigate the etiology, clinical features, diagnosis, therapy and prognosis of adult Still's diseases by the retrospective analysis. Methods:24 adult with Still's diseases diagnosed in our hospital in 1993-2001 were studied on clinical features, diagnosis and treatment systematically. Results:There were18 misdiagnosed with the misdiagnositc time ranging from 28 days to 13 months( averaging 85 days), Metacen and glucocorticoid were effective to most patients; 14 of 24 pateints were followed up: of which 6 recovered completely , 1 of 8 relapsed patients accompanied with hemophagocytic syndrome was misdiagnosed as MH, 2 died from relapse of adult Still's diseases. Conclusion: The etiologogy and pathogenesis of adult Still's diseases were not yet to resolve, and it might be correlated with infection, immunologic reaction and rheumatoid arthritis. Adult Still's diseases was mainly characterized by fever,tetter and arthro-symptom,and it was easily misdiagnosed. Diagnose should be made depending on excluding other diseases, good response to NSAID and glucocorticoid. Bacterial infection and side effect of cortex hormone were among the leading cause of death.