血清阴性寡关节炎23年随访研究

骨科医师之家  2013年8月13日  阅读数:780  字体:    

Seronegative Oligoarthritis: A 23-Year Follow-up Study

血清阴性寡关节炎23年随访研究

Purpose

目的

     The aim of the study was to investigate the long-term outcome of non-specific seronegative oligoarthritis in adults.

     本研究的目的是调查成年人非特异性血清阴性寡关节炎的长期疗效。

Patients and Methods

患者和方法

    The study included 64 adult patients with recent (<6 months) seronegative oligoarthritis (rheumatoid factor negative, number of swollen joints 1–4 during the first 6 months). Follow-up examinations were carried out at onset and at 1, 3 and 8 years from entry. A total of 47 patients attended the 23-year follow-up.

该研究纳入64名成年患者,于6个月内患有血清阴性寡关节炎(类风湿因子阴性,前6个月关节肿胀数为1-4)。分别在发病初始及发病后1、3、8年对患者进行随访检查。最终共有47名患者参与了这项23年随访研究。

Results

结果

The endpoint outcome was good. Seven had mild erosions in the hands or feet. Only one patient with HLA-B27 developed bilateral sacroiliitis. Three patients had retired from work because of joint disease. The functional outcome of the patients analysed by HAQ was very good after 23 years: 0 in 33 and 0.1–0.9 in 12 of the 47 patients. Reclassification revealed a certain heterogeneity: one case each of rheumatoid arthritis, SLE and ankylosing spondylitis, two cases of post-traumatic arthritis, four of osteoarthrosis, and six of possible reactive arthritis. Out of the remaining 49 patients 15 were HLA-B27 positive and 16 had at least one of the psoriasis-related HLA antigens (HLA-B13, 17, w16).

      患者的最终结果较理想。7名患者手足部有轻度糜烂。只有一名HLA-B27患者发展成双侧骶髂关节炎。3例患者由于关节疾病无法工作。HAQ法分析显示,23年后患者的功能性疗效很理想:47例患者中33例为012例为0.1-0.9。对患者的最终疗效进行重新分类,显示出一定的异质性:类风湿性关节炎、系统性红斑狼疮(SLE)、强直性脊柱炎各一例,创伤性关节炎两例,骨关节炎四例,可能患有反应性关节炎六例。剩余的49例患者中,15例HLA-B27为阳性,16例患者有至少一个银屑病相关HLA抗原(HLA-B13,17,w16)。

Conclusions

结论

In conclusion, our 23-year prospective follow-up study of patients with seronegative oligoarthritis confirms their favourable outcome. The reason is that the endpoint diagnoses seemed to be similar to those of mild spondylarthropathies.

总之,我们对血清阴性寡关节炎患者进行23年前瞻性随访研究,证实患者疗效良好。其依据是最终诊断结果似乎与轻度脊柱关节病相似。

责任编辑:马黎,王影影