35例硬皮病住院病例临床分析

Clinical analysis of 35 patients with scleroderma in hospital

目的探讨硬皮病住院患者的临床特点及治疗效果。方法回顾性分析了35例住院硬皮病患者的临床表现、实验室检查、辅助检查及治疗结果,并对局限性和系统性硬皮病相关指标进行比较。结果硬皮病最常见首发部位在四肢,系统性硬皮病抗核抗体(60.0%)、免疫球蛋白(64.0%)、谷丙转氨酶(52.0%)、谷草转氨酶(36.0%)异常率较高,系统损害以关节疼痛(44.4%)、肺部损害(24.0%)、心电图检查异常(40.0%)等改变较为常见,系统性硬皮病的内脏损害及辅助检查的异常率高于局限性硬皮病,且关节疼痛发生率(P=0.011)和抗核抗体阳性率(P=0.001)增高,差异有显著性。通过血管活性药、免疫抑制剂及抗纤维药物等综合治疗,取得一定疗效。结论系统性硬皮病关节疼痛和抗核抗体阳性率比局限性硬皮病显著升高。本病目前尚无特效治疗方法,应早期检查以明确有无系统损害。

Objective To explore clinical features and therapeutic effects of patients with scleroderma in hospital. Methods 35 patients were analyzed retrospectively by clinical manifestations, laboratory, auxiliary examination, and therapeutic results, simultaneously, compared related indexes of local with system scleroderma. Results The first onset locus was common on extremities. In patients with system scleroderma, the rates of abnormality in arthrosis pain （44. 4% ）, ANA （ 60.0% ）, immune globulin （ 64. 0% ）, glutamate-pyruvate transaminase （ 52. 0% ）, glutamic-oxalacetic transaminase（36.0% ）, lung damage（24.0% ） and EKG（40. 0% ） were high. The rates of abnormality in arthrosis pain（P = 0. 011 ） and ANA（P = 0. 001 ） were higher in system scleroderma than in local ones. The patients acquired some curative effects by vasoactive drugs, antifihrosis drugs and immunodepressants. Conclusion The rates of abnormality in arthrosis pain and ANA were higher in system scleroderma than in local ones. No special method may be used in it, so the patients should he checked to comprehend system damages in earlier period.