缓解性血清阴性对称性滑膜炎伴凹陷性水肿综合征与血清阴性类风湿性关节炎患者临床和实验室特征比较

doi:10.3969/j.issn.1004-583X.2022.03.012

摘要/Abstract

摘要：

目的探讨缓解性血清阴性对称性滑膜炎伴凹陷性水肿(remitting seronegative symmetrical synovitis with pitting edema, RS3PE)综合征和血清阴性类风湿性关节炎(seronegative rheumatoid arthritis,SNRA)区别。方法收集2009年1月至2020年12月期间在我院诊治的RS3PE综合征患者(RS3PE综合征组)12例,收集同期SNRA患者(SNRA组) 36例,比较两组一般资料、临床特征和实验室特征。结果与SNRA组比较,RS3PE综合征组年龄较大,以男性多见,血清C反应蛋白(C-reactive protein,CRP)较高,多累及踝关节,累及小关节、手关节少见,易合并肿瘤(均P<0.05)。结论与SNRA患者比较,RS3PE综合征患者更可能为老年男性,CRP水平相对较高,合并肿瘤的风险更高,更易累及踝关节。此外,年龄较大、男性、有肢体水肿的RS3PE综合征患者应积极进行恶性肿瘤筛查。

关键词: 关节炎,类风湿, 滑膜炎, 炎症

Abstract:

Objective To investigate the difference between remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome and seronegative rheumatoid arthritis (SNRA). Methods During January 2009 to December 2020, a total of 12 patients with RS3PE syndrome (RS3PE group) admitted in our hospital were enrolled, and 36 patients with SNRA (SNRA group) during the same period were collected. In-group general data, clinical features and laboratory indexes were included as comparison. Results Compared with the SNRA group, the patients in the RS3PE group had older aged, more males, higher serum C-reactive protein (CRP), more involved in ankle joints, less involved in small joints and hand joints, and easy to combine tumor (all P<0.05). Conclusion Older men and relatively higher CRP levels are higher risk for combined tumors in patients with RS3PE syndrome, they are more likely to involve the ankle joint. A actively screened for malignancy should be carried out in older, male, and RS3PE syndrome patients with limb edema.

Key words: arthritis,rheumatoid, synovitis, inflammation

中图分类号:

R593.22

林长艺, 宋明辉, 吴培埕. 缓解性血清阴性对称性滑膜炎伴凹陷性水肿综合征与血清阴性类风湿性关节炎患者临床和实验室特征比较[J]. 临床荟萃, 2022, 37(3): 262-265.

Lin Changyi, Song Minghui, Wu Peicheng. Difference between remitting seronegative symmetrical synovitis with pitting edema syndrome and seronegative rheumatoid arthritis[J]. Clinical Focus, 2022, 37(3): 262-265.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2022.03.012

https://huicui.hebmu.edu.cn/CN/Y2022/V37/I3/262

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参考文献 16

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组别	例数 (例)	年龄 (岁)	性别[例(%)]		病程 (月)	身高 (cm)	体质量 (kg)
组别	例数 (例)	年龄 (岁)	男	女	病程 (月)	身高 (cm)	体质量 (kg)
SNRA组	36	61.9±5.1	9(25.0)	27(75.0)	12.1±4.4	161.4±6.5	62.6±8.4
RS3PE综合征组	12	73.5±4.4	7(58.3)	5(41.7)	11.5±5.1	165.3±5.8	67.1±7.9
t/χ²值		6.421	4.500		-0.420	1.892	1.633
P值		0.001	0.034		0.654	0.065	0.109

组别	例数 (例)	年龄 (岁)	性别[例(%)]		病程 (月)	身高 (cm)	体质量 (kg)
组别	例数 (例)	年龄 (岁)	男	女	病程 (月)	身高 (cm)	体质量 (kg)
SNRA组	36	61.9±5.1	9(25.0)	27(75.0)	12.1±4.4	161.4±6.5	62.6±8.4
RS3PE综合征组	12	73.5±4.4	7(58.3)	5(41.7)	11.5±5.1	165.3±5.8	67.1±7.9
t/χ²值		6.421	4.500		-0.420	1.892	1.633
P值		0.001	0.034		0.654	0.065	0.109

组别	例数	大关节肿胀	小关节肿胀	受累关节
组别	例数	大关节肿胀	小关节肿胀	肩关节	肘关节	腕关节	手关节	髋关节	膝关节	踝关节	足关节
SNRA组	36	20(55.6)	36(100.0)	10(27.8)	6(16.7)	29(80.6)	32(88.9)	2(5.6)	8(22.2)	7(19.4)	10(27.8)
RS3PE综合征组	12	6(50.0)	8(66.7)	6(50.0)	1(8.3)	8(66.7)	7(58.3)	1(8.3)	5(41.7)	6(50.0)	5(41.7)
χ²值		0.112	13.091	2.000	0.502	0.983	5.516	0.119	1.723	4.255	0.808
P值		0.738	0.001	0.157	0.479	0.322	0.019	0.731	0.189	0.039	0.369

组别	例数	大关节肿胀	小关节肿胀	受累关节
组别	例数	大关节肿胀	小关节肿胀	肩关节	肘关节	腕关节	手关节	髋关节	膝关节	踝关节	足关节
SNRA组	36	20(55.6)	36(100.0)	10(27.8)	6(16.7)	29(80.6)	32(88.9)	2(5.6)	8(22.2)	7(19.4)	10(27.8)
RS3PE综合征组	12	6(50.0)	8(66.7)	6(50.0)	1(8.3)	8(66.7)	7(58.3)	1(8.3)	5(41.7)	6(50.0)	5(41.7)
χ²值		0.112	13.091	2.000	0.502	0.983	5.516	0.119	1.723	4.255	0.808
P值		0.738	0.001	0.157	0.479	0.322	0.019	0.731	0.189	0.039	0.369

组别	例数	2型糖尿病	高血压	高脂血症	骨质疏松	间质性肺病	肿瘤
SNRA组	36	7(19.4)	12(33.3)	10(27.8)	24(66.7)	4(11.1)	1(2.7)
RS3PE综合征组	12	3(25.0)	6(50.0)	5(41.7)	6(50.0)	1(8.3)	3(25.0)
χ²值		0.168	1.067	0.808	1.067	0.074	5.818
P值		0.682	0.302	0.369	0.302	0.785	0.016