18 例以下呼吸道受累為首發表現的復發性多軟骨炎臨床分析_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

周世雄 ^1,2 , 胡遠麗 ³ ,  羅鳳鳴 ¹ , 楊小東 ¹

1. ;
2. ;
3. ;

Corresponding?author：

羅鳳鳴, Email: luofengming@hotmail.com

Keywords：

復發性多軟骨炎; 下呼吸道受累; 診斷治療

DOI：

10.7507/1671-6205.202006077

Video：

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目的分析以下呼吸道受累為首發表現的復發性多軟骨炎的臨床特征，以提高診斷和治療水平。方法收集四川大學華西醫院 2015 年 1 月至 2018 年 12 月收治的以下呼吸道受累為首發表現的復發性多軟骨炎住院患者 18 例臨床資料，進行回顧性分析，并進行相關文獻復習。結果 18 例患者中，男 13 例，女 5 例，年齡 26～71 歲。癥狀：咳嗽 17 例（94%），咳痰 16 例（89%），氣緊 15 例（83%），發熱 7 例（39%），聲嘶 6 例（33%），胸痛 4 例（22%）。計算機體層成像（CT）及支氣管鏡發現狹窄或黏膜腫脹增厚 17 例（94%）。1 例行氣管切開，安置氣管套管。11 例單用糖皮質激素治療，6 例使用糖皮質激素聯合免疫抑制劑治療，1 例放棄治療。結論復發性多軟骨炎患者在疾病早期臨床癥狀無特異性，易造成不重視，同時易出現誤診漏診。CT、氣管鏡檢查及正電子發射計算機體層成像對確診有較大臨床意義。糖皮質激素和免疫抑制劑治療有效。

Citation： 周世雄, 胡遠麗, 羅鳳鳴, 楊小東. 18 例以下呼吸道受累為首發表現的復發性多軟骨炎臨床分析. Chinese Journal of Respiratory and Critical Care Medicine, 2021, 20(3): 206-208. doi: 10.7507/1671-6205.202006077 Copy

1.	Dharssi S, Wong-Rieger D, Harold M, et al. Review of 11 national policies for rare diseases in the context of key patient needs. Orphanet J Rare Dis, 2017, 12(1): 63.
2.	Hazra N, Dregan A, Charhon J, et al. Incidence and mortality of relapsing polychondritis in the UK: a population-based cohort study. Rheumatology (Oxford), 2015, 54(12): 2181-2187.
3.	Vitale A, Sota J, Rigante D, et al. Relapsing polychondritis: an update on pathogenesis, clinical features, diagnostic tools, and therapeutic perspectives. Curr Rheumatol Rep, 2016, 18(1): 3.
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7.	史旭華, 佟勝全, 蘇金梅, 等. 復發性多軟骨炎呼吸道受累的特點. 中華醫學雜志, 2006, 86(15): 1048-1051.
8.	陳楠, 王振剛. 復發性多軟骨炎病理及發病機制的研究進展. 中華風濕病學雜志, 2019, 23(3): 207-211.
9.	Shimizu J, Oka H, Yamano Y, et al. Cutaneous manifestations of patients with relapsing polychondritis: an association with extracutaneous complications. Clin Rheumatol, 2016, 35(3): 781-783.
10.	Kong KO, Vasoo S, Tay NS, et al. Relapsing polychondritis--an Oriental case series. Singapore Med J, 2003, 44(4): 197-200.
11.	張海艇, 王立, 閆琳毅, 等. 復發性多軟骨炎患者臨床特征分析. 中華醫學雜志, 2015, 95(29): 2375-2378.
12.	Zamora T, Urrutia J, Schweitzer D, et al. Do orthopaedic oncologists agree on the diagnosis and treatment of cartilage tumors of the appendicular skeleton?. Clin Orthop Relat Res, 2017, 475(9): 2176-2186.
13.	Yamashita H, Takahashi H, Kubota K, et al. Utility of fluorodeoxyglucose positron emission tomography/computed tomography for early diagnosis and evaluation of disease activity of relapsing polychondritis: a case series and literature review. Rheumatology (Oxford), 2014, 53(8): 1482-1490.
14.	Lekpa FK, Chevalier X. Refractory relapsing polychondritis: challenges and solutions. Open Access Rheumatol, 2018, 10: 1-11.
15.	張輝, 王國春. 復發性多軟骨炎呼吸道受累的臨床診治進展. 中日友好醫院學報, 2011, 25(1): 51-53.
16.	高永平, 周云芝. 累及氣道的復發性多軟骨炎 27 例治療分析. 臨床肺科雜志, 2019, 9: 1618-1621.

1. Dharssi S, Wong-Rieger D, Harold M, et al. Review of 11 national policies for rare diseases in the context of key patient needs. Orphanet J Rare Dis, 2017, 12(1): 63.
2. Hazra N, Dregan A, Charhon J, et al. Incidence and mortality of relapsing polychondritis in the UK: a population-based cohort study. Rheumatology (Oxford), 2015, 54(12): 2181-2187.
3. Vitale A, Sota J, Rigante D, et al. Relapsing polychondritis: an update on pathogenesis, clinical features, diagnostic tools, and therapeutic perspectives. Curr Rheumatol Rep, 2016, 18(1): 3.
4. Greco A, Gallo A, Fusconi M, et al. Cogan's syndrome: an autoimmune inner ear disease. Autoimmun Rev, 2013, 12(3): 396-400.
5. McAdam LP, O'Hanlan MA, Bluestone R, et al. Relapsing polychondritis: prospective study of 23 patients and a review of the literature. Medicine (Baltimore), 1976, 55(3): 193-215.
6. 中華醫學會風濕病學分會. 復發性多軟骨炎診斷和治療指南. 中華風濕病學雜志, 201l, 15(7): 481-483.
7. 史旭華, 佟勝全, 蘇金梅, 等. 復發性多軟骨炎呼吸道受累的特點. 中華醫學雜志, 2006, 86(15): 1048-1051.
8. 陳楠, 王振剛. 復發性多軟骨炎病理及發病機制的研究進展. 中華風濕病學雜志, 2019, 23(3): 207-211.
9. Shimizu J, Oka H, Yamano Y, et al. Cutaneous manifestations of patients with relapsing polychondritis: an association with extracutaneous complications. Clin Rheumatol, 2016, 35(3): 781-783.
10. Kong KO, Vasoo S, Tay NS, et al. Relapsing polychondritis--an Oriental case series. Singapore Med J, 2003, 44(4): 197-200.
11. 張海艇, 王立, 閆琳毅, 等. 復發性多軟骨炎患者臨床特征分析. 中華醫學雜志, 2015, 95(29): 2375-2378.
12. Zamora T, Urrutia J, Schweitzer D, et al. Do orthopaedic oncologists agree on the diagnosis and treatment of cartilage tumors of the appendicular skeleton?. Clin Orthop Relat Res, 2017, 475(9): 2176-2186.
13. Yamashita H, Takahashi H, Kubota K, et al. Utility of fluorodeoxyglucose positron emission tomography/computed tomography for early diagnosis and evaluation of disease activity of relapsing polychondritis: a case series and literature review. Rheumatology (Oxford), 2014, 53(8): 1482-1490.
14. Lekpa FK, Chevalier X. Refractory relapsing polychondritis: challenges and solutions. Open Access Rheumatol, 2018, 10: 1-11.
15. 張輝, 王國春. 復發性多軟骨炎呼吸道受累的臨床診治進展. 中日友好醫院學報, 2011, 25(1): 51-53.
16. 高永平, 周云芝. 累及氣道的復發性多軟骨炎 27 例治療分析. 臨床肺科雜志, 2019, 9: 1618-1621.

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18 例以下呼吸道受累為首發表現的復發性多軟骨炎臨床分析

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