摘要
目的分析银屑病关节炎（ＰＡ）的临床特点及与ＨＬＡＢ２７的相关性。方法选５５例住院患者，总结分析其皮疹和关节炎、关节外表现、Ｘ线特征及骶髂关节炎与ＨＬＡＢ２７的关系。结果３６例皮疹先于关节炎出现，１３例关节炎在先，６例同时发生。３８例有指甲改变。手足小关节最易受累，共计４５例，占８１８％，２８例（６２２％）伴远端指间关节（ＤＩＰ）受累。２８例有关节外表现。２０例有手足小关节Ｘ线破坏征，１９例出现骶髂关节炎或脊柱炎。３８例检测ＨＬＡＢ２７，１９例（５０％）为阳性，其中有骶髂关节炎者为８４２％（１６／１９）。结论伴ＤＩＰ受累的寡关节炎是ＰＡ的特征性表现，中轴关节受累常无症状，并与ＨＬＡＢ２７密切相关。治疗应选择对皮疹及关节炎均有效的甲氨蝶呤或环孢霉素Ａ，以及包括金制剂、柳氮磺胺吡啶等在内的联合方案。
Objective
To analyse the clinical characters of psoriatic arthritis (PA) and their relationship with
HLAB27.THZMethods Fiftyfive PA inpatients were chosen and analysed for the relationship
between psoriasis and arthritis,extraarticular features,radiographic findings and the association
between sacroiliitis(spondylitis)and HLAB27. Results The male to female ratio was 151,but the
ratio in patients with axial involvement was 851.Psoriasis antedated the arthritis in 36 patients
and followed it in 13.An isochronous onset occurred in 6Nail involvement was found in 38
patients.The small joint of hand or foot involvement was noted in 45 patients,distal
interphalangeal joint (DIP) involvement in 28.Various extraarticular features were observed in
28 patients.Erosions and destructions of the small joints on Xray were noted in 20
patients,sacroiliitis(spondylitis) in 19.HLAB27 was positive in 50% (19/38) of patients,but the
positive rate of HLAB27 increased to 842% (16/19) in patients with sacroiliitis(spondylitis).
Conclusion Oligoarthritis with DIP involvement is a characteristic manifestation of PA.The axial
joint involvement is usually not the presenting symptoms and is associated with
HLAB27.Combining scheme,including MTX,Gold or Cyclosporine,which have reproducible
effects on both articular and cutaneous manifestations,should be chosen for treatment.
出处
《中华风湿病学杂志》
CAS
CSCD
1999年第2期87-89,共3页
Chinese Journal of Rheumatology
