2019 年第 4 期 第 14 卷

复发性多软骨炎气道受累的临床特点及误诊概况

Clinical features and misdiagnosis of airway involvement in relapsing polychondritis

作者：杨西超巴燕娜吴振彪吕婷婷

英文作者：

单位：710032西安，空军军医大学第一附属医院临床免疫科（杨西超、巴燕娜、吴振彪）；710038西安，空军军医大学第二附属医院风湿免疫科（吕婷婷）

英文单位：

关键词：复发性多软骨炎；气道受累；误诊；临床表现

英文关键词：

• 摘要：

• 【摘要】目的    探讨复发性多软骨炎（RP）气道受累的临床特点及误诊概况，以提高早期诊断的准确率。方法    回顾性分析2010年1月至2017年1月空军军医大学第一附属医院出院时诊断为RP的80例患者的病历资料，依据入院时诊断是否为RP，分为初诊诊断组（48例）和初诊误诊组（32例）。结果    RP患者气道临床症状居前3位者为呼吸困难或憋喘（62例，77.5%）、声音嘶哑（48例，60.0%）、咳嗽痰多（45例，56.2%）。初诊误诊组耳廓软骨炎比例明显低于初诊诊断组［22.5%(9/32)比52.5%(21/48)］，差异有统计学意义（P＝0.012）。初诊诊断组喉部、气管及主支气管同时受累比例高于初诊误诊组［41.7%（20/48）比15.6%（5/32）］，差异有统计学意义（P＝0.002）。RP患者易被误诊为哮喘（10例）、咽喉炎及支气管炎（11例）等。初诊误诊组气管切开比例较高［81.2%（26/32）］。结论    广泛的气道累及以及耳廓软骨炎在RP的确诊中有一定价值，利于早期诊断。

• 【Abstract】Objective    To explore the clinical features and misdiagnosis profile of airway involvement in relapsing polychondritis(RP). Methods    Clinical data of 80 patients diagnosed of RP in the First Affiliated Hospital of Air Force Military Medical University from January 2010 to January 2017 were retrospectively analyzed. According to whether they were misdiagnosed on the first admission, the patients were divided into correct diagnosis group（48 cases） and misdiagnosis group（32 cases）. Results    The first three airway manifestations of RP were dyspnea or wheezing［62 cases(77.5%)］, hoarseness［48 cases(60.0%)］, cough and sputum［45 cases(56.2%)］. Rate of auricular cartilage inflammation in the misdiagnosis group was significantly lower than that in the correct diagnosis group［22.5%(9/32) vs 52.5%(21/48)］（P＝0.012）. Rate of laryngeal, tracheal and main bronchial simultaneous involvements in the correct diagnosis group was higher than that in the misdiagnosis group［41.7%（20/48） vs 15.6%（5/32）］（P＝0.002）. Airway involvement of RP can be misdiagnosed of asthma（10 cases）, pharyngitis and bronchitis（11 cases）. Tracheotomy rate in the misdiagnosis group was high［81.2%（26/32）］. Conclusion    Extensive airway involvement and auricular cartilage inflammation show some indicative value in the early diagnosis of RP.