儿童风湿性疾病561例回顾性分析

Retrospective analysis of juvenile rheumatic disease in 561 cases

目的了解河南地区儿童风湿性疾病(JRD)的患病情况、地区分布、各种JRD的构成比、首发症状、主要症状和实验室检查等临床特点,增加对JRD的认识。方法对1990年1月至2003年8月在河南省人民医院儿科住院的561例JRD患者进行回顾性分析。结果过敏性紫癜(HSP)、幼年特发性关节炎(JIA)、风湿热(RF)、儿童系统性红斑狼疮(SLE)农村患者均多于城市,川崎病(MCLS)城市患者较多,儿童风湿性疾病的首发症状以关节痛、皮疹、发热最多见,主要症状以皮疹、关节痛和发热最多见,主要累及器官为肾脏、淋巴结、心脏和肝脏。43.1%的JRD患者白细胞升高,61.6%的患者血沉(ESR)升高,类风湿因子阳性以JIA最多见,本组病例死亡3例。结论JRD在儿科住院中的百分比为2.9%,最常见的病种为HSP、JIA、MCLS、RF、SLE,HSP发病有升高的趋势,RF发病呈下降趋势,需加强对JRD患者的认识,提高诊断和治疗水平是控制病情、减少并发症的关键。

Objective To analyze the condition, distribution, constituent ratio, main symptoms, laboratory examination and other clinical features of juvenile rheumatic disease (JRD) in order to enhance theunderstanding of it. Methods Five hundred and sixty-one cases of JRD treated in the Department of Pediatrics of Henan Provincial People′s Hospital were analyzed retrospectively from January 1990 to August 2003. Results Henoch-Schonlein purpura (HSP), juvenile idiopathic arthritis(JIA), rheumatic fever (RF), systemic lupus erythematosus (SLE) occurred more in rural area than in urban. Mucocutaneous lymphnode syndrome (MCLS) occurred more in urban than in rural area.The initial symptoms of JRD were arthralgia, skin rashes and fever. The frequently involved organs were kidney, lymphnode, heart and liver. White blood cell count and erythrocyte sedimentation rate raised in 43.1% and 61.6% patients with JRD respectively. Rheumatoid factor was mostly positive in JIA. Three patients died. Conclusion 2.9% patients with JRD have been admitted to Department of Pediatrics. The most common diseases are HSP, JIA, MCLS, RF, SLE. The morbidity of HSP shows an increasing tendency and RF shows decreasing tendency. It is suggested to enhance the understanding of JRD. Improve the diagnostic and treatment level is the key to control disease and reduce complications.