摘要
目的总结白塞病(Beh?et’s disease,BD)关节受累患者的临床及超声影像特征,探讨关节受累与其他临床表现的相关性。方法收集2009年5月至2017年12月北京大学第一医院风湿免疫科BD患者的临床资料,分析出现关节受累患者的临床特征、实验室检查及关节超声资料,总结BD患者中发生关节病变的临床和超声影像特点,分析关节受累与BD其他临床表现的相关性。结果入选157例BD患者中49例(31.2%)出现关节受累,其中46例资料完备。女性18例(占女性患者的32.1%),男性28例(占男性患者的27.7%)。受累关节多为中大关节,其中膝关节受累最常见(27例,58.7%),其次为踝关节(19例,41.3%),小关节受累较少。46例患者中少关节(2~4个)受累型最多见(29例,63.0%),其次为单关节受累型(11例,23.9%),多关节(≥5个)受累型最少见(6例,13.0%)。BD主要累及外周关节(100%),其中1例合并骶髂关节受累。活动组BD患者的ESR、CRP高于稳定组(P值均<0.001),但有或无关节受累的BD患者之间ESR、CRP差异无统计学意义(P>0.05),23例有关节症状的患者行关节超声检查,7例(30.4%)存在滑膜炎或滑膜增生,5例(21.8%)存在肌腱炎或腱周炎,2例(8.7%)存在滑囊炎,1例(4.3%)存在肌腱端炎,均未发现骨侵蚀。单因素相关分析显示,BD患者的其他器官受累与是否发生关节受累均无相关性(P均>0.05)。结论 BD累及关节并不少见,主要累及下肢中、大关节,表现为关节痛和(或)关节炎,寡关节型表现为主,中轴关节受累少见。超声检查未发现无骨侵蚀,提示预后较好。BD患者关节受累与其它系统性临床表现无相关性。
Objective To investigate the clinical and ultrasonographic features of joint involvement in patients with Beh?et’s disease(BD),and further analyze its correlation with other clinical manifestations. Methods The clinical data of patients with BD who visited our center from May 2009 to December 2017 were retrospectively collected. The clinical features of patients with articular involvements,laboratory tests and joint ultrasound data were analyzed. The clinical and ultrasonic features in BD patients were summarized, and the relationship between joint involvement and other clinical manifestations was analyzed. Results Joint involvement occurred in 49(31.2%)of 157 patients. 46 of them with complete data. There were 18 females(accounting for 32.1% of all female patients)and 28 males(accounting for 27.7% of all male patients).Most of the affected joints were medium and large joints. Knee was the most frequently involved joint(27 cases,58.7%),followed by ankle(19 cases,41.3%),while small joints were rare. Oligo-joint(2 to 4 joints)involvement(29 cases,63.0%) was most common,followed by mono-joint involvement(11 cases,23.9%) and multiple joint(affected joints ≥ 5)involvement(6 cases,13.0%). Peripheral joints were affected(100%)in all patients,and 1 patient also had sacroiliac joint involvement. ESR and CRP were significantly higher in patients in active stage than those in stable stage(both P<0.001);however,no significant difference was found in ESR or CRP levels between BD patients with and those without joints involvement(P>0.05). Ultrasonography data of involved joints in 23 patients was collected,synovitis or synovial hyperplasia was found in 7(30.4%)patients,tendinitis or peritendinitis in 5(21.8%)patients,bursitis in 2(8.7%)patients,and enthesitis in 1(4.3%)patient;no bone erosion existed in any joint. Univariate correlation analysis showed that there was no correlation between other organ involvement and joints involvement(all P>0.05). Conclusion Joint involvement is not rare in BD, with involving mainly mediu
作者
邓雪蓉
何德宁
孙利平
张卓莉
DENG Xue-rong;HE De-ning;SUN Li-ping;ZHANG Zhuo-li(Department of Rheumatology and Clinical Immunology,First Hospital of Peking University,Beijing 100034,China)
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2020年第6期497-501,共5页
Chinese Journal of Practical Internal Medicine
基金
北京大学第一医院青年研究专项课题(2018CR04)
首都卫生发展科研专项项目(首发2011-4021-03)。
关键词
白塞病
关节受累
临床
超声
Behcet's disease
joint involvement
clinical
ultrasound
