以关节炎为首发表现的银屑病关节炎患者的临床及实验室特征

Clinical and laboratory features of psoriatic arthritis which antedates psoriasis

目的 探讨以关节炎为首发表现的银屑病关节炎（PsA）的临床表现及实验室指标的特点.方法 回顾性分析1993至2015年,于北京大学人民医院住院的113例PsA患者的一般情况、关节受累特征、实验室指标,包括血常规、生化、动态红细胞沉降率（ESR）、C反应蛋白（CRP）、免疫球蛋白（IG）、类风湿因子（RF）及HLA-B27等,并将关节炎首发者和银屑疹首发者进行分组比较.结果 22.1％ （25/113）的PsA患者以关节炎为首发表现,关节炎发生早于皮疹之前的2个月～25年;该组患者远端指间关节（DIPJ）受累常见,髋关节受累较为少见;HLA-B27阳性率为40％;血小板、ESR、CRP、IgA升高者常见.结论 以关节炎首发的PsA患者DIPJ受累多见,炎性指标升高明显,病情活动度高.

Objective To analyze the clinical and laboratory features of psoriatic arthritis （PsA） which antedates psoriasis.Methods The clinical and laboratory data including erythrocyte sedimentation rate （ESR）,C-reactive protein （CRP）,immunoglobulins,antibodies of 113 patients with PsA were analyzed retrospectively and compared by order of the occurrence of arthritis.Results The occurrence of psoriatic arthritis which antedates psoriasis was 22.1％ in the study.The onset of arthritis was 2 months to 25 years earlier than psoriasis.Arthritis of distal interphalangeal （DIP） joints was frequently involved in this group and arthritis of hip joints was rare.Positive HLA-B27 and higher level of platelet （PLT）,ESR,CRP,and IgA were common in patients with psoriatic arthritis which antedates psoriasis.Conclusion Arthritis of DIP joints and elevated inflammatory markers are frequently involved in patients with psoriatic arthritis which antedates psoriasis,and somewhat they are associated with disease activity.