51例斯蒂尔病血液学异常变化及临床分析

Hematological abnormal changes and clinical analysis of 51 cases of Still’s disease

目的对斯蒂尔病(Still’sdisease)患者临床症状和血液学指标进行分析,研究患者临床症状和血液学指标变化的相关性,以期为临床的快速准确诊断提供科学依据。方法收集并分析51例斯蒂尔病患者的临床血液学资料,通过统计学分析方法,分析该病诊断的关键指标。结果51例患者白细胞超标率为56.9%,中性粒细胞超标率为76.5%;铁蛋白浓度超标率为72.5%;血沉和C反应蛋白浓度超标率分别为90.2%和88.2%;在中性粒细胞比例、C反应蛋白浓度和铁蛋白浓度指标上女性患者灵敏度高于男性患者,男性患者在白细胞、血沉指标上灵敏度高于女性患者;C反应蛋白与白细胞、中性粒、血沉和铁蛋白之间有显著相关性。主成分分析结果显示,血液指标的变化是斯蒂尔病诊断的关键因素。结论斯蒂尔病表观特征是以关节痛、肌痛及皮疹等特征的不明原因的持续高烧,血液中铁蛋白、C反应蛋白、白细胞的浓度升高及中性粒细胞比例提高和血沉加快。通过对关键指标的分析,为斯蒂尔病患者及早发现提供准确的诊断依据,为早治疗争取时间,从而降低其复发率和死亡率。

Objective To analyze the clinical symptoms and hematological parameters of patients with Still's disease, and to study the correlation between clinical symptoms and hematological index changes, in order to provide a scientific basis for rapid and accurate clinical diagnosis. Methods The clinical hematology data of 51 patients with Still's disease were collected and analyzed. The key indicators of the diagnosis were analyzed by statistical analysis. Results In the 51 patients, the white blood cell over-standard rate was 56.9%, the neutrophil over-standard rate was 76.5%, and the ferritin concentration over-standard rate was 72.5%. And the over-standard rate of erythrocyte sedimentation and C-reactive protein concentration was 90.2% and 88.2%, respectively. The sensitivity of women in neutrophil proportion, C-reactive protein and ferritin concentrations was higher than that of male patients, while the sensitivity of male patients in leukocyte, erythrocyte sedimentation was higher than that of female patients. There was a significant correlation between C-reactive protein and leukocytes, neutrophils, erythrocyte sedimentation rate, ferritin. Principal component analysis showed that changes in blood parameters were a key factor in the diagnosis of Still's disease. Conclusion The apparent characteristics of Still's disease are unexplained persistent high fever characterized by joint pain, myalgia and rash, the increase of concentration of ferritin, C-reactive protein and leukocytes in the blood and the increase of proportion of neutrophils and the elevation of blood sedimentation. Through the analysis of key indicators, it provides an accurate diagnosis basis for early detection of patients with Still's disease, and strives for time for early treatment, thereby reducing their recurrence rate and mortality.