儿童和成人still病临床表现的特征

THE CLINICAL MANIFESTATIONS OF STILL′S DISEASE IN CHILDREN AND ADULT

目的 为提高对still病的认识。方法 报道 34例确诊的Still病的临床特征。结果 临床特征 :10 0 %发热 ,79.4%关节肿痛 ,41.2 %皮疹 ,94.1%血沉 (ESR)增快 ,88.2 %C反应蛋白 (CRP)增快 ,76 .4%WBC升高 ,38.2 %血清铁蛋白 (SP)增高 ,血类风湿因子 (RF)及血培养均阴性 ,76 .4%抗核抗体 (ANA)阴性。幼年型慢性关节炎 (JOSD)和成人Still病 (AOSD)在临床表现、病程及实验室检查无明显差异 ,严重的关节畸形、功能受限见于JOSD。结论 Still病以发热、关节肿痛、皮疹、WBC增高、ESR增快、CRP及血清蛋白增高 ,RF、ANA及血培养阴性为主要临床表现。关节炎在JOSD与AOSD症中的预后不同。早期诊断 ,给予糖皮质激素和免症抑制剂是改善预后的关键。

Objective To know the manifestation of Still′s disease.Methods Analysis was carried on the clinical manifestation of patient in Still′s disease Result The clinical feature:fever 100% arthralgia 79.4% rash 41.2%,increased 94.1% erythrocyte sedimentation rate,higher C reaction protem 88.2% higher white blood count76.4%.38.2% higher serum ferritin,negative rheumatoid factor,negative blood culture,76.4% negative antinuclear antibody,there was no significant difference in the initial clinical and laboratory manifestation severe deforming marked functional limitation occurred only in JOSD.Conclusion Clinical feature of Stills disease is fever,arthralgia,rash:higher WBC,incrersed ESR,higher CRP,higher SP,negative RF,negative ANA,negative blood culture.There was difference outcome of arthritis in JOSD and AOSD.there was favour outcome in Still′s disease for early diagnosis and used steroid and immunosuppressant.