Clinical Features And Therapeutic Effect Analysis Of 48 Cases Of Relapsing Polychondritis

BackgroundRecurrent polychondritis(RP)is a relatively rare disease,with the characteristic of ecurrent degenerative cartilage inflammation,its specific etiology and mechanism is not clear.the research evidence that the pathogenesis and autoimmune response are closely related to trauma,allergies,inflammation and other factors to stimulate the cartilage matrix,so that exposure to antigenicity,resulting in the body of cartilage tissue local or Tissue of the same matrix,such as sclera,uvea,vitreous,optic nerve intima,nerve bundle membrane,medial and inner connective tissue of the aorta,heart valve,tracheal submucosal basement membrane,synovial membrane and glomeruli and kidney Tubule base film,etc.Lesions can cause a single organ inflammatory disease,it can also involve or multiple organs,tissue destruction,manifested as eye,ear,nose,throat,trachea and bronchus,joints,kidney and heart valves and other organ lesions,about half or The onset of the symptoms or the progress of the throat,trachea and bronchial inflammation of the destruction,recurrent,easily misdiagnosed or missed.The population incidence rate of this disease is low,and its specific pathogenesis is unclear,its clinical manifestations are not typical,clinical workers lack of awareness of the disease,Pathological changes is not prominent characteristics,Combined with the lack of specificity of serological indexes,imaging is not easy.It was found that the cartilage pathological biopsywas the gold standard for the diagnosis of the disease.But due to that the organization is to obtain a traumaticoperations,the tissue specimen is not easy to getand the related literature was less likely to result in a series of factors,thoseleads to clinical medical workers on the lack of awareness of the disease,it leading to prolong the patient's average such confinement,increase the economic burden of patients and society.Therefore,we should understand the epidemiological characteristics of the disease;attaches great importance to the clinical manifestations;further to explore the pathogenesis of the disease;study its specific laboratory indicators;improve the recognition of the imaging features of the disease;familiar with the diagnosis of the disease Standard;explore the effective treatment program to strengthen the prognosis of patients;prognosis of patients with follow-up work.ObjectiveTo explore the epidemiological characteristics of recurrent polychondritis,clinical manifestations,laboratory tests,imaging,diagnostic criteria,complications,treatment and efficacy.To investigate the differences in sex,age of onset,complication,urban and rural distribution,misdiagnosis rate,laboratory examination,diagnosis time,comorbidities and outcome of respiratory tract involvement and respiratory tract involvement,and to improve the medical workers,especially the respiratory department Doctors on the disease awareness,diagnosis and treatment level.MethodsCollected during January 2011 to July 2016 in the first affiliated hospital of zhengzhou university more than all of the diagnosis of recurrent cartilage inflammation in patients with clinical data,including patient gender,age,clinical manifestation,The first clinical situation,laboratory examination,such as white blood cell(WBC),hemoglobinemia(HB),blood platelet(PLT),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),D – dimer(D-D),fibrinogen(FIB),rheumatoid factor(RF),imaging manifestations,other test(fiberoptic bronchoscopy examination,pulmonary function),biopsy,complication,treatment and follow-up,etc.Analyze the clinical characteristics and treatment effect,and analyze the clinical characteristics and therapeutic effect.And the total sample group,involving the respiratory tract and not involving the respiratory group,respectively on two groups of gender,the average onset age,urban and rural distribution,the misdiagnosis rate,serological indexes,confirmed time,complications and outcome of the comparison.Using SPSS 21.0 software for drawing and statistical analysis.In accordance with normal distribution measurement variable datause expression: X ± s,comparison between two groups of independent sample use the t test,four table counter variable data by chi-square test,single independent variable risk factors analysis using Logistic regression.inspection standards are alpha = 0.05.ResultsTotal sample results1.Clinical features(1)sex,age: 48 patients,30 males and 18 females,the age of onset 11 to 72 years,the average age of onset(44 ± 14)years.(2)involved parts:There were 23 cases involving the ear involvement,17 cases involving the joint involvement,12 cases involving the eye involvement,8 cases involving the nose and 3 cases involving the skin.(3)respiratory symptoms: 23 cases of respiratory symptoms,cough in 18 cases,17 cases of sputum,chest tightness in 14 cases,6 cases of dyspnea,chest pain in 5cases,4 cases of hoarseness,asthma in 3 cases,1 case of drinking water cough.2.Diagnosis: 16 cases diagnosed as RP,missed or misdiagnosed in 32 cases,misdiagnosed as respiratory disease in 21 cases,3 cases of ear disease,eye disease in1 case,1 case of skin diseases,autoimmune 1 case of sexually transmitted diseases,fever to be investigated in 5 cases.3.Laboratory examination: 48 cases of RF,WBC increased 37 cases,HB decreased in 30 cases,PLT increased in 21 cases,increased ESR in 27 cases,CRP increased in 31 cases,FIB increased in 25 cases,DD increased by 25,RF increased in14 cases.4.Imaging examination: 23 cases of chest CT;2 patients with chest MRI.5.Pulmonary function: 10 cases of pulmonary function.6.Bronchoscope: 10 patients underwent bronchoscopy.7.Histopathology: 6 cases of tissue biopsy.8.Complications: 15 cases combined with other diseases.9.Treatment: 9 cases of symptomatic treatment,no application of glucocorticoids;37 cases were treated with glucocorticoid treatment;2 cases of biological agents;48cases of RP patients,8 patients died.Respiratory tract involvement group and respiratory non-involvement group Comparison results1.Have respiratory tract involvement of RP patients compared with the RP patients without respiratory tract involvement,incidence between two groups in gender,average onset age,urban and rural distribution,time and serological diagnosis of some indicators such as the WBC,HB,PLT and RF has no difference;2.There were differences in misdiagnosis rate,complication,outcome and some indicators such as ESR,CRP,D-D and FIB in the two groups.ConclusionsRecurrent cartilage inflammation involving one or more organs.About half of the patients are in the respiratory tract.RP patients with respiratory tract and those who do not involve the respiratory tract in the misdiagnosis rate,complications,the treatment effect are different,involving the respiratory tract with poor prognosis,high mortality,so that early diagnosis and timely treatment to improve the survival of patients.