肺部损害后成人斯蒂尔病临床特征分析

Clinical analysis of adult-type Still's disease with lung damage

目的探讨有肺部损害后成人斯蒂尔病(adult-onset Still's disease,AOSD)的临床特点及诊断、治疗体会。方法回顾性分析6例胸部高分辨率CT(HRCT)上有肺部病变的A0SD患者临床表现、实验室检查、影像学特点等临床资料。结果肺部影像学表现各有不同,但部对抗生素无效,对激素治疗敏感、使用激素后,无论是实变影、斑片影,还是网格影、磨玻璃影均很快吸收。但在治疗方面,有肺部损害患者大多需要激素联合免疫抑制药治疗。结论当AOSD患者出现肺部损害时,应积极治疗,特别是需要长期激素+免疫抑制药治疗,并要求其长期随访。

Objective To study the clinical characteristics, diagnosis and treatment of adult - type Still＇s disease with lung damage. Methods Clinical and laboratory data of six patients with adult Still＇s disease and abnormality shown by chest high resolutinn CT （HRCT） were analyzed retrospectively. Results Despite the different manifestations of chest HRCT, the antibiotic treatment was ineffective. However, glueocorticuld could clear up the opacities, patch video, grid shadow, and ground glass quickly. In case of lung lesions, cortical hormone therapy was administered combined with immunosuppresslve agents. Conclusions Aduh -type Still＇s disease is a clinical syndrome with multi -system involvement, the cause anti pathogenesis of which remain unknown. High fever, transient skin rash, arthralgia and increased white blood cells are considered to be the main characteristics of the disease. Cortieoid therapy is often effective, and the majority of patients show good prognosis.