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目的 为提高对still病的认识。方法 报道 34例确诊的Still病的临床特征。结果 临床特征 :10 0 %发热 ,79.4%关节肿痛 ,41.2 %皮疹 ,94.1%血沉 (ESR)增快 ,88.2 %C反应蛋白 (CRP)增快 ,76 .4%WBC升高 ,38.2 %血清铁蛋白 (SP)增高 ,血类风湿因子 (RF)及血培养均阴性 ,76 .4%抗核抗体 (ANA)阴性。幼年型慢性关节炎 (JOSD)和成人Still病 (AOSD)在临床表现、病程及实验室检查无明显差异 ,严重的关节畸形、功能受限见于JOSD。结论 Still病以发热、关节肿痛、皮疹、WBC增高、ESR增快、CRP及血清蛋白增高 ,RF、ANA及血培养阴性为主要临床表现。关节炎在JOSD与AOSD症中的预后不同。早期诊断 ,给予糖皮质激素和免症抑制剂是改善预后的关键。
The purpose is to improve the understanding of still disease. Methods The clinical features of 34 cases with Still’s disease were reported. Results Clinical features: 10 0% fever, 79.4% joint pain, 41.2% rash, 94.1% ESR, 88.2% C reactive protein (CRP), 76.4% WBC elevation, 38.2% serum Ferritin (SP) increased, blood rheumatoid factor (RF) and blood culture were negative, 76.4% anti-nuclear antibody (ANA) negative. Juvenile chronic arthritis (JOSD) and adult Still disease (AOSD) in the clinical manifestations, duration and laboratory tests showed no significant difference in severe joint deformity, functional limitations seen in JOSD. Conclusions Still’s disease has the main clinical manifestations of fever, joint swelling and pain, rash, increased WBC, increased ESR, increased CRP and serum proteins, and negative RF, ANA and blood cultures. Arthritis has a different prognosis in JOSD and AOSD disorders. Early diagnosis, glucocorticoid and drug-free inhibitor is the key to improving the prognosis.