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目的 探讨幼年型Still病与成人型Still病的临床特点及治疗经验。方法 采用回顾性研究方法比较分析 42例幼年型Still病与 47例成人型Still病的临床表现、实验室检测指标及治疗方案。结果 幼年型Still病患者淋巴结肿大、咽痛、腹痛的发生率明显高于成人患者 (P <0 0 5 ) ,而成人Still病患者的肌痛、脾肿大发生率明显高于幼年患者 (P <0 0 5 ) ;实验室检查两组患者均有不同程度的贫血及白细胞、血小板增高 ,骨髓细胞学检查表现为粒系增生活跃 ,中性粒细胞内有中毒颗粒 ,类似感染的骨髓象。血沉 (ESR)与C反应蛋白 (CRP)在疾病活动期显著升高 ,类风湿因子 (RF)与抗核抗体 (ANA)多为阴性。治疗上 ,普遍应用肾上腺皮质激素及非甾体类抗炎药 ,慢作用药的使用较少。结论 Still病幼年型与成人型临床表现各有特点 ,掌握特点以利于早期诊断。药物治疗要注意毒副作用 ,以达到良好的治疗效果
Objective To investigate the clinical features and treatment of juvenile Still’s disease and adult Still’s disease. Methods A retrospective study was conducted to compare the clinical manifestations, laboratory tests and treatment of 42 cases of Still’s disease and 47 cases of Still’s disease. Results The incidence of swollen lymph nodes, sore throat and abdominal pain in juvenile Still’s disease patients was significantly higher than that in adult patients (P <0.05), while the incidence of myalgia and splenomegaly in adult Still disease patients was significantly higher than that of juvenile patients P <0 05). There were different degrees of anemia and leucocyte and thrombocytopenia in both groups in the laboratory examination. The bone marrow cytology showed active hyperplasia of granulocytes, toxic particles in neutrophils, similar infection of bone marrow . Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were significantly increased in the active phase of the disease, mostly negative for rheumatoid factor (RF) and antinuclear antibodies (ANA). Treatment, the general application of adrenal cortex hormones and non-steroidal anti-inflammatory drugs, slow-acting drugs less used. Conclusion Still disease and adult clinical manifestations have their own characteristics, grasp the characteristics in favor of early diagnosis. Drug treatment should pay attention to side effects in order to achieve good therapeutic effect