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目的:通过对53例成人Still病例临床资料进行回顾性分析,以提高对该病的诊疗水平。方法:回顾性分析我院53例成人Still病患者的临床资料、辅助检查和疾病预后转归情况。结果:在回顾性分析中,女性患者较男性患者例数更多(52.8%vs.47.2%),发生严重并发症如多器官功能损害、噬血综合征等的患者预后较差。基线降钙素原、白介素-6、C反应蛋白、血沉、白细胞计数、中性粒细胞百分比在不同预后患者之间无明显差异。预后好患者治疗后铁蛋白水平明显低于预后差患者[(4 898±8 938)μg/L vs.(31 810±17 710)μg/L,P<0.001],预后好患者在治疗后铁蛋白水平较治疗前明显下降[(4 898±8 938)μg/L vs.(14 270±19 070)μg/L,P<0.001],预后差患者治疗后铁蛋白水平较治疗前仍持续上升[(31 810±17 710)μg/L vs.(15 240±22 150)μg/L,P<0.001]。结论:成人Still病是以发热、皮疹、关节疼痛为主要特征的一类疾病,铁蛋白对患者的诊断和治疗具有较好的预测效果,大部分患者通过治疗预后较好,少部分出现严重并发症的患者预后差。
Objective: To retrospectively analyze the clinical data of 53 cases of Still Still in order to improve the diagnosis and treatment of this disease. Methods: A retrospective analysis of 53 cases of Still Still patients in our hospital clinical data, laboratory tests and prognosis prognosis. Results: In the retrospective analysis, the number of female patients was significantly higher than that of male patients (52.8% vs.47.2%). The patients with severe complications such as multiple organ dysfunction and hemophagocytic syndrome had poor prognosis. Baseline procalcitonin, interleukin-6, C-reactive protein, erythrocyte sedimentation rate, white blood cell count, neutrophil percentage were not significantly different between patients with different prognosis. Patients with good prognosis had significantly lower levels of ferritin after treatment than those with poor prognosis [(4898 ± 8 938 μg / L vs. (31 810 ± 17 710) μg / L, P <0.001] Protein levels were significantly lower than those before treatment [(4898 ± 8 938) μg / L vs. (14 270 ± 19 070) μg / L, P <0.001]. The levels of ferritin in patients with poor prognosis continued to increase [(31 810 ± 17 710) μg / L vs. (15 240 ± 22 150) μg / L, P <0.001]. CONCLUSIONS: Adult Still disease is a type of disease characterized by fever, rash and joint pain. Ferritin has a good predictive value in the diagnosis and treatment of patients. Most patients have a good prognosis through treatment, and a small proportion of them have severe complications Patients with poor prognosis.