复发性多软骨炎(附3例报告及文献复习)

Relapsing polychondritis:With a report of 3 cases and literature review

目的 :研究复发性多软骨炎的临床表现、诊断与鉴别诊断以及治疗与预后。方法 :总结 3例诊断为复发性多软骨炎患者的临床表现及治疗方法。例 1先出现鼻梁塌陷 ,后出现声嘶、呼吸困难。气管切开后带管出院 ,未确诊。 4个月后又因双耳胀痛 ,胸骨旁隐痛、发热 ,再次住院 ,诊断为复发性多软骨炎。例 2首发症状亦是鼻梁塌陷 ,2年后出现右眼突 ,诊断为此病。例 3首发症状为耳郭红、肿、热、痛 ,诊断为耳郭软骨膜炎。 3个月后出现声嘶 ,按喉炎治疗 ,效果不明显 ,后诊断为复发性多软骨炎。结果 :经用类固醇、硫唑嘌呤等药物治疗后 ,分别随访 1 5年、2年、6年无复发。结论

Objective:To investigate the clinical manifestation,diagnosis,differential diagnosis,therapy and prognosis of relapsing polychondritis.Methods:3 cases were reviewed.One case had bridge,of nose collapsed in the early stage,then presented hoarseness and dyspnea.After tracheotomy,the patient left with intubation without confirmed diagnosis.Four months later,with swelling pain of the ears,vague pain of the parasternal and fever,the patient was diagnosed as relapsion polychodritis.The initial symptoms of case 2 were bridge of nose collapsed,and protruding eyeballs 2 years later.The first symptoms of case 3 were red,swollen,fever and pain of the auricle.After 3 months, the patient presented hoarseness and was diagnosed as relapsing polychondritis.Result:As treated by corticosteroids,azathiopurine,all cases have had no relapse after the 1.5,2,6 yesrs follow up respectively.Conclusion: Relapsing polychondritis should be treated with drug therapy.