[1]李高洁,丁丽,王怡怡,等.多学科联合门诊中银屑病性关节炎36例临床分析[J].中国皮肤性病学杂志,2020,(11):1262-1266.[doi:10.13735/j.cjdv.1001-7089.202002074]
 LI Gaojie,DING Li,WANG Yiyi,et al.Clinical Analysis of 36 Cases of Psoriatic Arthritis in Multi-Disciplinary Team Outpatient Department[J].The Chinese Journal of Dermatovenereology,2020,(11):1262-1266.[doi:10.13735/j.cjdv.1001-7089.202002074]
点击复制

多学科联合门诊中银屑病性关节炎36例临床分析()
分享到:

《中国皮肤性病学杂志》[ISSN:1001-7089/CN:61-1197/R]

卷:
期数:
2020年11期
页码:
1262-1266
栏目:
临床经验
出版日期:
2020-11-01

文章信息/Info

Title:
Clinical Analysis of 36 Cases of Psoriatic Arthritis in Multi-Disciplinary Team Outpatient Department
文章编号:
1001-7089(2020)11-1262-05
作者:
李高洁1丁丽1王怡怡1Krista Shrestha1郭瑞倩2杨闵3邱逦2刘畅4赵毅3李薇1
1.四川大学华西医院皮肤性病科,四川 成都 610041; 2.四川大学华西医院超声科,四川 成都 610041; 3.四川大学华西医院风湿免疫科,四川 成都 610041; 4.四川大学华西医院放射科,四川 成都 610041
Author(s):
LI Gaojie1DING Li1WANG Yiyi1KRISTA Shrestha1GUO Ruiqian2YANG Min3QIU Li2LIU Chang4ZHAO Yi3LI Wei1
1.Department of Dermatovenereology,West China Hospital,Sichuan University,Chengdu 610041,China; 2.Department of Ultrasound,West China Hospital,Sichuan University,Chengdu 610041,China; 3.Department of Rheumatology and Immunology,West China Hospital,Sichuan University,Chengdu 610041,China; 4.Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,China
关键词:
银屑病性关节炎 多学科 临床分析
Keywords:
Psoriatic arthritis Multidisciplinary team Clinical analysis
分类号:
R 758.63
DOI:
10.13735/j.cjdv.1001-7089.202002074
文献标志码:
B
摘要:
目的 探讨多学科联合门诊在银屑病性关节炎(PsA)诊断和治疗中的意义。方法 回顾性分析2015年10月-2019年10月四川大学华西医院银屑病多学科联合门诊就诊的69例患者的病史资料,对诊断为银屑病性关节炎患者的临床特征进行分析。结果 银屑病性关节炎36例,无关节受累及患其他关节炎者共33例。银屑病性关节炎患者中,男女比例为2:1,关节发病年龄平均(38.97±12.72)岁; 皮损先于关节症状出现者33例(91.67%); 银屑病外周关节高频超声显示常见受累关节为手小关节,常见异常征象包括滑膜炎、附着点炎等。多因素Logistics回归分析显示:甲受累及银屑病病程>10年与PsA发生相关。结论 银屑病性关节炎易被误诊及延迟诊断,其早期发现和诊治需要多学科合作,其中,皮肤科医生应针对有关节症状及高风险的银屑病患者进行早期筛查及转诊。
Abstract:
Objective To explore the significance of diagnosis and treatment of psoriatic arthritis in multidisciplinary outpatient clinic.Methods This was a retrospective analysis of medical records of 69 patients who attended multidisciplinary outpatient clinic in West China Hospital of Sichuan University from October,2015 to October,2019.The clinical features of patients diagnosed with psoriatic arthritis were analysed.Results Out of 69 patients,36 cases were psoriatic arthritis,while 33 were patients without joint involvement and patients with other arthritis.In patients with psoriatic arthritis,the ratio of males to females was 2:1,and the mean age at onset of arthritis was(38.97±12.72)years.There were 33 patients,accounting for 91.67%,with skin lesions earlier than joint symptoms.It was showed in the high frequency ultrasound of psoriatic peripheral joints that common affected joints were small joints of hands,and common abnormal signs include synovitis,enthesitis,etc.Logistic regression analysis indicated nail psoriasis as well as a more than 10-year duration of psoriasis were associated with psoriatic arthritis.Conclusion Psoriatic arthritis is easy to be misdiagnosed and delayed in diagnosis; its early identification,diagnosis and treatment require multidisciplinary cooperation,in which dermatologists should carry out early screening and referral for psoriasis patients with joint symptoms and high risks.

参考文献/References:

[1] Mease P,Gladman D,Papp K,et al.Prevalence of rheumatologist-diagnosed psoriatic arthritis in patients with psoriasis in European/North American dermatology clinics[J].J Am Acad Dermatol,2013,69(5):729-735.
[2] Villani AP,Rouzaud M,Sevrain M,et al.Prevalence of undiagnosed psoriatic arthritis among psoriasis patients:systematic review and meta-analysis[J].J Am Acad Dermatol,2015,73(2):242-248.
[3] Yang Q,Qu L,Tian H,et al.Prevalence and characteristics of psoriatic arthritis in Chinese patients with psoriasis[J].J Eur Acad Dermatol,2011,25(12):1409-1414.
[4] Taylor W,Gladman D,Helliwell P,et al.Classification criteria for psoriatic arthritis:development of new criteria from a large international study[J].Arthritis Rheum,2006,54(8):2665-2673.
[5] Henes JC,Ziupa E,Eisfelder M,et al.High prevalence of psoriatic arthritis in dermatological patients with psoriasis:a cross-sectional study[J].Rheumatol Int,2014,34(2):227-234.
[6] Ogdie A,Langan S,Love T,et al.Prevalence and treatment patterns of psoriatic arthritis in the UK[J].Rheumatology(Oxford),2013,52(3):568-575.
[7] Khraishi M,Chouela E,Bejar M,et al.High prevalence of psoriatic arthritis in a cohort of patients with psoriasis seen in a dermatology practice[J].J Cutan Med Surg,2012,16(2):122-127.
[8] Gladman DD,Antoni C,Mease P,et al.Psoriatic arthritis:epidemiology,clinical features,course,and outcome[J].Ann Rheum Dis,2005,64(Suppl 2):ii14-17.
[9] Scotti L,Franchi M,Marchesoni A,et al.Prevalence and incidence of psoriatic arthritis:a systematic review and meta-analysis[J].Semin Arthritis Rheum,2018,48(1):28-34.
[10] 党育平,徐荣,李东光,等.银屑病性关节炎36例临床分析[J].中国麻风皮肤病杂志,2012,28(7):474-476.
[11] Ranganathan V,Gracey E,Brown MA,et al.Pathogenesis of ankylosing spondylitis-recent advances and future directions[J].Nat Rev Rheumatol,2017,13(6):359.
[12] Ritchlin CT,Colbert RA,Gladman DD.Psoriatic arthritis[J].New Engl J Med,2017,376(10):957-970.
[13] Kvien TK,Uhlig T,Ødegård S,et al.Epidemiological aspects of rheumatoid arthritis:the sex ratio[J].Ann N Y Acad Sci,2006,1069(1):212-222.
[14] 唐远姣,向茜,杨裕佳,等.寻常型及关节型银屑病附着点炎超声特征对比分析[J].四川大学学报(医学版),2017,48(4):589-594.
[15] Scher JU,Ogdie A,Merola JF,et al.Preventing psoriatic arthritis:focusing on patients with psoriasis at increased risk of transition[J].Nat Rev Rheumatol,2019,15(3):153-166.
[16] 李萌萌,徐飞,闫薇,等.临床诊断为寻常性银屑病的患者与健康人外周关节超声改变的比较[J].中国皮肤性病学杂志,2018,32(3):263-268.

备注/Memo

备注/Memo:
[基金项目] 国家自然科学基金面上项目(81573050) [通信作者] 李薇,E-mail:liwei476@wchscu.cn
更新日期/Last Update: 2020-11-16