摘要
通过对50例初诊为混合性结缔组织病(MCTD)患者进行了2~8年的临床随访,对Sharp、Kasukawa及Alarcon-Segovia提出的3个诊断标准的可靠性进行了考核,并对其中38例进行HLA-A,-B,-DR抗原分型研究。结果示:50例MCTD中有13例(26.0%)转变为其他结缔组织病(CTD),在符合Sharp标准的MCTD患者中仅1例(4.3%)转变为其他CTD,而符合Kasukawa标准但不符合Sharp标准的23例患者中有7例(30.4%)转变为其他CTD,符合Alarcon-Segovia标准,但不符合Sharp标准的27例患者中有12例(44.4%)转变为其他CTD。此外,在符合Sharp标准的患者中HLA-DR4,-DR5抗原频率(60.9%,56.5%)较正常对照(24.3%,21.4%)明显增高(RR分别为=4.7和4.6,Pc<0.05),而在不符合Sharp标准的患者组中未发现HLA-DR4及DR5抗原频率增高(P>0.05)。结论:(1)在目前国际上仅有的3个MCTD诊断标准中以Sharp标准对本病诊断最为可靠。(2)MCTD为一独立性疾病,其遗传背景与HLA-DR4,-?
Mixedconnectivetissuedisease(MCTD)asadistinctclinicalentityisstilcontrover-sial.Toaddresstheissue,theauthorsobservedtheevolutionof50patientsdiagnosedasMCTDatourclinic,evaluatedthereliabilityofthreedifferentdiagnosticcriteriaproposedbySharp,Alarcon-SegoviaandKasukawarespectivelyandperformedHLA-A,-Band-DRantigentypingin38ofthepatients.Theresultsshowedthat:(1)13(26.0%)ofthe50MCTDpatientssubsequentlydevelopedothercon-nectivetissuedisease(OCTD)including7systemiclupuserythematosus(SLE),and6progressivesys-temicscleroderma(PSS).(2)among23oftheMCTDpatientsfulfilingSharp′scriteria,1(4.3%)de-velopedPSS,butamong23ofthepatientsfulfilingKasukawa′s,notSharp′s,7(30.4%)developedOCTDandamong27ofthepatientsfulfilingAlarcon-Segovia′s,notSharp′s,12(44.4%)developedOCTD.(3)inthefrequenciesofDR4andDR5,thereweresignificantdiferencesbetweenpatientsful-filingSharp′s(60.9%,56.5%)andthenormalcontrols(24.3%,P<0.005,RR=4.7and21.4%,P<0.005,RR=4.6%),butnosignificantdifferencesbetweenthepatientsnotfulfilingSharp′sandnormalcontrols(P>0.05).Weconcludedthat:(1)MCTDisadistinctrheumaticdisease.(2)Sharp′scriteriaisthemostreliablefordiagnosisofMCTD.
出处
《中华内科杂志》
CAS
CSCD
北大核心
1996年第10期694-697,共4页
Chinese Journal of Internal Medicine
关键词
胶原病
MCTD
诊断标准
MixedconnectivetissuediseaseDiagnosis