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目的研究自身免疫性风湿病(ARDs)合并皮肤溃疡患者的临床特点,治疗方法和效果。方法回顾性调查1998年至2008年中山大学附属第一医院ARDs合并皮肤溃疡住院患者的病例资料,分析ARDs患者皮肤溃疡的临床特点,各种治疗方法的效果。结果共有67例ARDs合并皮肤溃疡住院患者,126个溃疡,男女比例为1:3.1(16:51),平均年龄(50.9±19.2)岁。70%患者溃疡发生时处于疾病活动期。绝大部分患者伴有多种器官系统受累和基础疾病,其中血象改变和低白蛋白血症常见。大部分溃疡在应用糖皮质激素和缓解病情抗风湿药物控制病情活动后保守治疗愈合或好转,或通过手术修复愈合。结论ARDs患者皮肤溃疡的发生及其临床表现与ARDs本身密切相关,治疗上应首先控制ARDs病情活动,再结合全身和局部情况决定手术或非手术治疗,并辅以综合治疗。
Objective To study the clinical features, treatment methods and effects of patients with autoimmune rheumatism (ARDs) and skin ulcers. Methods The data of hospitalized patients with ARDs combined with skin ulcer in the First Affiliated Hospital of Sun Yat-sen University from 1998 to 2008 were retrospectively analyzed. The clinical characteristics of skin ulcers and the effect of various treatment methods were analyzed. Results A total of 67 ARDs hospitalized patients with skin ulcers, 126 ulcers, male to female ratio of 1: 3.1 (16:51), mean age (50.9 ± 19.2) years old. 70% of patients with ulcer disease in the active stage. The vast majority of patients with a variety of organ system involvement and underlying diseases, including blood changes and hypoalbuminemia common. Most ulcers in the application of glucocorticoid and relieve the disease antirheumatic drugs to control the disease activity of conservative treatment of healing or improvement, or healing by surgery. Conclusion The incidence and clinical manifestations of skin ulcers in patients with ARDs are closely related to the ARDs itself. The treatment of ARDs should be the first to control the disease activity, combined with systemic and local conditions to determine the surgical or non-surgical treatment, combined with comprehensive treatment.