关节病型银屑病30例临床分析

Clinical analysis of 30 cases of psoriasis arthritis

目的：总结关节病型银屑病的临床特点。方法：对30例关节病型银屑病患者的临床资料进行回顾性分析。结果：本组病例的平均发病年龄为31．4岁，男：女为1：1。以皮损为首发者26例（86．6％）；皮损和关节症状同时出现者2例（6．7％）；以关节炎为首发者2例（6．7％）。皮损类型为寻常型27例（90％）。关节炎分类为对称性多关节炎型12例（40％）；其次为远端指（趾）关节炎型7例（23．3％）；非对称性关节炎型6例（20％）；最后为残毁性关节炎型3例（10％）；脊柱关节病变型2例（6．7％）。经x线检查的26例患者中，23例阳性（88．5％）。常见的改变有关节间隙变窄、骨质疏松、骨质吸收等。结论：各型银屑病皮损都可伴发关节炎病变。对称性多关节炎和远端指（趾）关节炎、非对称性少数关节炎是本病的主要特点。

Objective： To investigate the clinical features of psoriatic arthritis （PsA）. Methods： The clinical data on 30 patients with PsA were analysed retrospectively. Results： Among the 30 patients, the average age of onset was 31.4 year - old with a male to female ratio of 1 ： 1. The skin lesions presented piror to arthritis in 26 cases （86.6%）. Both skin and joint symptoms appeared simultaneously in 2 cases （6.7%） and arthritis piror to skin lesions occurred in other 2 cases （6.7%）. Psoriasis vulgaris accounted for 90% （27/30）. Twelve cases （40%） presented as symmetrical polyarthritis, the others were distal interphalangeal predominant in 7 （23.3%）, asymmetrical arthritis 6 （20%）, arthritis multilans 3 （ 10 % ） and spondyloarthropathy 2 （6.7 % ）. Joint damages were demonstrated in 23 （88.5 % ） of 26 cases received X - ray examinations. The common radiological findings were narrow of joint space, osteporosis and erosive changes. Conclusion： Arthropathy can be observed in all the types of psoriasis. Symmetrical polyarthritis, distal interphalangeal joints and asymmetrical arthritis are the characteristics of PsA.