成人斯蒂尔病与不明原因发热临床分析

A clinical study of Still's disease in adults with fever of unknown origin

目的探讨不明原因发热(fever of unknown origin,FUO)中成人斯蒂尔病(adult—onset Still's disease,AOSD)的临床特征,以提高对本病的认识和诊断水平。方法回顾性分析解放军总医院2000-01至2007-12间689例FUO患者中127例AOSD的临床表现、辅助检查,并与FUO中感染性疾病等进行对比分析。结果 (1)本组FUO中AOSD在结缔组织病中所占比例最高53.8%(127/236);(2)关节痛、皮疹、咽痛、肌痛、肝酶、C-反应蛋白、血清铁蛋白增高的比例均高于感染性疾病组,差异有统计学意义(P均<0.05)。结论 AOSD是FUO中的一个常见病因,在FUO中出现关节痛、皮疹、咽痛、肌痛、肝酶、C-反应蛋白、乳酸脱氢酶、血清铁蛋白增高应高度怀疑有此病。

Objective To study the clinical features of Still＇s disease （AOSD） in adult patients of with fever unknown origin （FUO） , in order to improve diagnosis. Methods The clinical manifestations and laboratory finolings of 127 AOSD patients among the total of 689 FUO eases were analyzed and compared with infected cases. Results （ 1 ） AOSD was the most common connective tissue disease （53.8% , 127/236） in FUO. （2） The percentage of arthralgia, rash, sore throat, myalgia , increased serum hepatic enzymes and CRP levels in AOSD was significantly higher than those in the infected cases （ all P 〈 0.05 ）. Conclusion AOSD is the most common disease in FUO. FUO patient with symptoms of arthralgia, rash, sore throat, myalgia , increased serum hepatic enzymes, CRP and LDH levels should he considered to have been afflicted with AOSD.