[1]白巧红.未分化结缔组织病的临床特点分析[J].医学信息,2020,33(04):109-111.[doi:10.3969/j.issn.1006-1959.2020.04.033]
　BAI Qiao-hong.Analysis of Clinical Characteristics of Undifferentiated Connective Tissue Disease[J].Medical Information,2020,33(04):109-111.[doi:10.3969/j.issn.1006-1959.2020.04.033]
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未分化结缔组织病的临床特点分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年04期
页码:
109-111
栏目:
临床研究
出版日期:
2020-02-15

文章信息/Info

Title:
Analysis of Clinical Characteristics of Undifferentiated Connective Tissue Disease
文章编号:
1006-1959（2020）04-0109-03
作者:
白巧红
（运城市中心医院风湿免疫科，山西 运城 044000）
Author(s):
BAI Qiao-hong
(Department of Rheumatology and Immunology,Yuncheng Central Hospital,Yuncheng 044000,Shanxi,China)
关键词:
未分化结缔组织病; 临床特点; 转归情况
Keywords:
ndifferentiated connective tissue disease; Clinical characteristics; Outcome
分类号:
R593.2
DOI:
10.3969/j.issn.1006-1959.2020.04.033
文献标志码:
A
摘要:
目的 了解未分化结缔组织病（UCTD）的临床特点及发展规律。方法 收集2015年1月~2019年1月运城市中心医院住院的128例UCTD患者临床资料，分析其一般临床症状、实验室检查结果、影像学表现及随访结果与转归情况。结果 128例UCTD患者，临床表现以关节症状为主，其次为雷诺现象、皮肤病变、口干眼干、发热、浆膜腔积液、口腔溃疡、肺纤维化。实验室指标中35例（27.34%）抗RNP抗体阳性，24例（18.75%）抗SSA抗体阳性，2例（1.56%）抗PM/SSC抗体阳性，11例（8.59%）RF阳性，其余抗体均为阴性；补体C3下降4例（3.13%），补体C4下降3例（2.34%），免疫球蛋白G增高21例（16.41%）。影像学检查中腹部彩超见肝脾、淋巴结肿大8例（6.25%），心脏彩超见心包积液2例（1.56%），肺部CT见胸腔积液7例（5.47%），肺纤维化2例（1.56%）。随访中2例失访，1例误诊，4例完全缓解，67例仍为UCTD（53.60%），54例发展为CTD（43.20%），其中17例分化为SLE，13例分化为SSC，11例分化为PSS，7例分化为PM/DM，5例分化为MCTD，1例分化为为RA。SLE、SSC、PSS、PM/DM患者不同临床症状占比比较，差异有统计学意义（P＜0.05）；MCTD患者不同临床症状占比比较，差异无统计学意义（P＞0.05）。结论 UCTD临床表现多样，少部分可能完全缓解，一部分可能持续未分化状态，一部分患者可进展为SLE、SSC、PSS、PM/DM、MCTD、RA。因此，了解UCTD的临床特点及转归情况对于改善患者预后至关重要。
Abstract:
Objective To understand the clinical characteristics and development rules of undifferentiated connective tissue disease (UCTD).Methods The clinical data of 128 UCTD patients admitted from January 2015 to January 2019 in Yuncheng Central Hospital were analyzed, and their general clinical symptoms, laboratory test results, imaging findings, and follow-up results and outcomes were analyzed.Results The clinical manifestations of 128 UCTD patients were mainly joint symptoms, followed by Raynaud’s phenomenon, skin lesions, dry mouth and dry eyes, fever, serous fluid, oral ulcers, and pulmonary fibrosis. Among the laboratory indicators, 35 cases (27.34%) were positive for anti-RNP antibodies, 24 cases (18.75%) were positive for anti-SSA antibodies, 2 cases (1.56%) were positive for anti-PM/SSC antibodies, 11 cases (8.59%) were positive for RF, and the remaining antibodies all were negative; complement C3 decreased in 4 cases (3.13%), complement C4 decreased in 3 cases (2.34%), and immunoglobulin G increased in 21 cases (16.41%). In the imaging examination, 8 cases (6.25%) of liver and spleen and lymph nodes were seen by color Doppler ultrasound of the abdomen, 2 cases (1.56%) of pericardial effusion of the sonography of the heart,CT of the lung showed pleural effusion in 7 cases (5.47%) and pulmonary fibrosis in 2 cases (1.56%). During follow-up, 2 cases were lost to follow-up, 1 case was misdiagnosed, 4 cases were completely resolved, 67 cases were still UCTD (53.60%), 54 cases developed CTD (43.20%), 17 of them were differentiated into SLE, 13 were into SSC, 11 cases was differentiated into PSS, 7 case was differentiated into PM/DM, 5 case was differentiated into MCTD, and 1 case was differentiated into RA. The proportion of different clinical symptoms in patients with SLE, SSC, PSS, PM/DM was statistically significant (P<0.05); the proportion of different clinical symptoms in MCTD patients was not statistically significant (P>0.05).Conclusion The clinical manifestations of UCTD are diverse. A small part may completely resolve, some may continue to be undifferentiated, and some patients may progress to SLE, SSC, PSS, PM/DM, MCTD, RA. Therefore, understanding the clinical characteristics and outcomes of UCTD is important to improve the prognosis of patients.

参考文献/References:

[1]李明.结缔组织病鉴别诊断的几个要点[C]//2018全国中西医结合皮肤性病学术年会,2018. [2]Mosca M,Tani C,Bombardieri S.Undifferentiated connective tissue diseases:a new frontier for rheumatology[J].Best Pract Res Clin Rheumatol,2007,21(6):1011-1023. [3]Andreoli L,Tincani A.Undifferentiated connective tissue disease,fibromyalgia and the environmental factors[J].Curr Opin Rheumatol,2017,29(4):355-360. [4]Bodolay E,Csiki Z,Szekanecz Z,et a1.Five-year follow-up of 665 Hungarian patients with undifferentiated connective tissue disease(UCTD)[J].Clin Exp Rheumatol,2003,21(3):313-320． [5]Watad A,Quaresma M,Bragazzi NL,et al.The autoimmune/inflammatory syndrome induced by adjuvants(ASIA)/Shoenfeld’s syndrome:descriptive analysis of 300 patients from the international ASIA syndrome registry[J].Clin Rheumatol,2018,37(2):483-493. [6]Lanata CM,Mahmood T,Fine DM,et al.Combination therapy of mycophenolate mofetil and tacrolimus in lupus nephritis[J].Lupus,2010,19(8):935-940. [7]Dijkstea S,Nieuwenhuys EJ,Swaak AJ.The prognosis and outcome of patients referred to an out patient clinic for rheumatic diseases characterized by the presence of antinuclear antibodies(ANA) [J].Scand J Rheumatol,1999(28):33-37. [8]Szodoray P,Nakken B,Barath S,et al.Progressive divergent shifts in natural and induced T-regulatory cells signify the transition from undifferentiated to definitive connective tissue disease[J].Int Immunol,2008,20(8):971-979. [9]Riccardi A,Marcoccia A,Borgia A,et al.Undifferentiated connective tissue disease at risk of systemic sclerosis:A weighted score to identify patients who will evolve[J].Autoimmun Rev,2019,18(9):102358.

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更新日期/Last Update: 2020-02-15