关节病性银屑病52例临床分析

Clinical analysis of 52 cases of psoriasis arthropathica

目的:探讨关节病性银屑病的临床特点。方法:对52例关节病性银屑病患者的临床资料进行回顾性分析。结果:本组病例平均发病年龄31岁,男:女为3.7:1。以皮损为首发者45例,占87％;皮损和关节症状同时出现者2例,占4％:以关节炎为首发者5例,占10％。皮损类型为寻常性32例,占62％;红皮病性9例,占17％;急性泛发性脓疱性11例,占21％。关节炎分类为远端指(趾)关节炎23例,占44％;类风湿性关节炎样型11例,占21％;非对称性少数大关节炎10例,占19％,主要为强直性脊柱炎8例,占15％。接受X线检查的39例中,30例阳性,占77％。结论:本病男性发病多于女性,各型银屑病皮损都可伴发关节炎病变。非对称性多发性关节炎和远端指(趾)关节易受累是本病的特点。小剂量糖皮质激素、雷公藤多苷、甲氨蝶呤、非甾体类抗炎药、秋水仙碱、柳氮磺胺吡啶、阿维A等合理联合应用可取得较好疗效。

Objective: To investigate the clinical features of psoriatic arthritis (PA). Methods: The clinical data of 52 patents with PA were analysed retrospectively. Results: Among the 52 patients, the average age of onset was 31 years old,and the ratio of male to female was 3.7 : 1. The skin lesions manifested prior to arthritis in 45 cases (87%). However, arthritis prior to skin lesions occurred only in 5 cases (10%), and both skin and joints symptoms appeared simultaneously in 2 cases (4%). The skin lesions could he classified into 3 types: psoriasis vulgaris (62%, 32/52), psoriatic erythroderma(17%, 9/52), generalized pustular psoriasis (21%, 11/52). As for the types of arthritis, 23 cases (44%) were distal interphalangeal arthritis, 11 cases (21%) rheumatoid-like arthritis, 10 cases (19%) asymmetrical arthritis of major joints, and 8 cases(15%) were ankylosing spondylitis. 39 cases received X-ray examinations, of which 30 cases revealed joint damages. Conclusions: Male patient outnumber females. Asymmetrical, multiple distal interphalangeal arthritis was the characteristic of PA. Low doses of corticosteroids, methotrexate, etretinate, Tripterygium wilfordii, colchicine, sulfasalazine and non-steroid anti-inflammatory drugs used in combination might have satisfactory results in the management of PA.