抗合成酶综合征合并多器官损害1例并文献分析

Anti-synthase syndrome complicated by multiple organ damage:one-case report and literature analysis

目的通过分析抗合成酶综合征合并间质性肺炎及心功能损害发病特点和诊疗过程,提高全科医师对该病的认知,明确该病的诊断,进而提高全科医师对该疾病的诊治水平,减少误诊漏诊。方法对西安医学院第一附属医院2020年2月诊治的因四肢乏力伴阵发性咳嗽2年、加重10 d入院的抗合成酶综合征合并间质性肺炎及心功能损害患者1例的临床症状、体征、实验室检查、诊疗过程、随访情况结合文献进行回顾性分析。结果通过全科医师SOAP问诊、体格检查及影像学检查,明确了疾病的诊断,再由风湿免疫科、呼吸内科、心血管内科专家共同会诊,然后转入风湿免疫科进行专科专病治疗,最后由全科门诊随访,该患者病情稳定后逐步恢复健康。结论多学科联合下针对抗合成酶综合征的诊治方案,能够提高全科医师对该疾病的认知,明确该疾病的诊断,并发挥全科医学科多学科协诊和基层首诊的优势。

Objective By analyzing the characteristics,diagnosis,and treatment process of anti-synthetase syndrome complicated by interstitial pneumonia and cardiac dysfunction,we aim to enhance general practitioners'understanding and diagnosis of this disease,thereby improving their level of diagnosis and treatment and reducing misdiagnoses and missed diagnoses.Methods A patient with anti-synthase syndrome complicated by interstitial pneumonia and cardiac dysfunction,who was admitted to The First Affiliated Hospital of Xi'an Medical University in February 2020 due to limb weakness accompanied by paroxysmal cough for 2 years and aggravated symptoms for 10 days,was included in this study.The patient's clinical symptoms,physical signs,laboratory examination results,diagnosis and treatment process,and follow-up were retrospectively analyzed based on previous literature.Results Through the general practitioner's SOAP consultation,physical examination,and imaging examination,the patient was diagnosed with anti-synthase syndrome complicated by interstitial pneumonia and cardiac dysfunction.Then rheumatology and immunology experts,respiratory medicine experts,and cardiovascular experts collaborated to provide a specialist diagnosis and treatment plan for the patient.Subsequently,the patient was referred to the department of rheumatology and immunology for specialized disease management.Finally,the patient was followed up in the general clinic.After the patient's condition stabilized,she gradually resumed her health.Conclusion The multidisciplinary diagnosis and treatment scheme for anti-synthase syndrome can enhance general practitioners'understanding of the disease,make the diagnosis of the disease,and fully leverage the advantages of multi-disciplinary consultation and primary diagnosis in general medicine.