\u90fd\u53f8\u5f71\u50cf\u4e13\u680f<\/p>\n
\u75c5\u4f8b\u56de\u987e<\/p>\n
1<\/p>\n
\u60a3\u8005\u75c5\u53f2 (Clinical history)<\/p>\n
\u00b7 \u4e00\u822c\u4fe1\u606f\uff1a\u5973\uff0c58\u5c81\uff0c\u56e0\u53d1\u73b0\u80f8\u9aa8\u67c4\u9aa8\u8d28\u7834\u574f1\u5468\u4e8e2021\u5e7412\u670801\u65e5\u5165\u9662<\/p>\n
\u00b7 \u73b0\u75c5\u53f2\uff1a\u60a3\u8005\u4e8e2019\u5e74\u5f00\u59cb\u51fa\u73b0\u4e0a\u80f8\u90e8\u75bc\u75db\u3001\u95f4\u65ad\u6027\u75bc\u75db\u3001\u5076\u6709\u52a0\u5267\uff0c\u540e\u5c31\u8bca\u4e8e\u6211\u9662\u80f8\u5916\u79d1<\/p>\n
\u00b7 \u4e8e2021-11-24\u5168\u8eab\u9aa8ECT\u63d0\u793a\u201c\u7ea6\u7b2c3\u8170\u690e\u3001\u5de6\u4fa7\u9ab6\u9ac2\u5173\u8282\u9aa8\u8d28\u4ee3\u8c22\u8f7b\u5ea6\u6d3b\u8dc3\uff0c\u53cc\u4fa7\u80f8\u9501\u5173\u8282\u53ca\u90bb\u8fd1\u80f8\u9aa8\u67c4\u9aa8\u8d28\u4ee3\u8c22\u660e\u663e\u6d3b\u8dc3\uff0c\u6027\u8d28\u5f85\u67e5\u201d<\/p>\n
\u00b7 2021-11-25\u884c\u80f8\u5ed3\u5e73\u626b+\u4e09\u7ef4\u91cd\u5efa+CT\u6210\u50cf\u201c\u53cc\u4fa7\u7b2c1\u524d\u808b\u3001\u808b\u8f6f\u9aa8\u53ca\u80f8\u9aa8\u67c4\u9aa8\u8d28\u7834\u574f\u201d<\/p>\n
2<\/p>\n
\u5f71\u50cf\u68c0\u67e5<\/p>\n
2021-11-25 \u25bc<\/p>\n
\u4e0a\u4e0b\u6ed1\u52a8\u67e5\u770b\u51717\u5f20\u5f71\u7247<\/p>\n
2021-12-12 \u25bc<\/p>\n
3<\/p>\n
\u75c5\u7406\u8bca\u65ad<\/p>\n
2021-12-08 \u80f8\u9aa8\u67c4\u7a7f\u523a\u75c5\u7406\uff08202165915\uff09\uff1a<\/p>\n
1.\uff08\u80f8\u9aa8\uff09\u6781\u5c11\u91cf\u7ec4\u7ec7\u89c1\u4e3a\u7ea4\u7ef4\u8102\u80aa\u7ec4\u7ec7\uff0c\u5c11\u91cf\u9aa8\u8d28\uff0c\u4f34\u9499\u5316\u3002\u8bf7\u7ed3\u5408\u4e34\u5e8a<\/p>\n
2. \u514d\u75ab\u7ec4\u5316\u7ed3\u679c\u663e\u793a:CK(\uff0d),EMA(\uff0d),Ki-67(\uff0d),Mum-1(\uff0d),\u03ba(\uff0d),\u03bb(\uff0d)<\/p>\n
2021-12-09\u80f8\u9aa8\u67c4\u7a7f\u523a\u6d3b\u68c0\u7ec6\u80de\u6d82\u7247\u75c5\u7406\uff08C20218702\uff09\uff1a<\/p>\n
\uff08\u80f8\u9aa8\uff09\u7a7f\u523a\u6d82\u7247\uff1a\u955c\u4e0b\u89c1\u8840\u6db2\u6210\u5206\uff0c\u5c11\u91cf\u6dcb\u5df4\u7ec6\u80de\uff0c\u8bf7\u7ed3\u5408\u4e34\u5e8a<\/p>\n
4<\/p>\n
\u4f1a\u8bca\u8bb0\u5f55<\/p>\n
\u00b7 2021-12-09 \u8bf7\u80f8\u5916\u79d1\u4f1a\u8bca\uff1a\u5efa\u8bae\u5b8c\u5584PET\/CT\u6392\u9664\u8f6c\u79fb\u7624\u540e\u624b\u672f\u6cbb\u7597<\/p>\n
\u00b7 2021-12-10 PET\/CT\uff1a\u80f8\u9aa8\u67c4\u5bc6\u5ea6\u589e\u9ad8\u5e76\u9aa8\u8d28\u7834\u574f\uff0c\u4ee3\u8c22\u589e\u9ad8\uff1b\u53cc\u4fa7\u7b2c\u4e00\u80f8\u808b\u5173\u8282\u9aa8\u8d28\u5bc6\u5ea6\u589e\u9ad8\u5e76\u9aa8\u8d28\u589e\u751f\uff0c\u4ee3\u8c22\u589e\u9ad8\uff1b\u98882-6\u690e\u4f53\u9aa8\u8d28\u5bc6\u5ea6\u589e\u9ad8\u5e76\u878d\u5408\u72b6\u6539\u53d8\uff0c\u90e8\u5206\u4ee3\u8c22\u7a0d\u589e\u9ad8\uff1b\u4e0a\u8ff0\u8003\u8651\u9aa8\u5173\u8282\u708e\uff0cSAPHO\u7efc\u5408\u5f81\u53ef\u80fd<\/p>\n
\u00b7 2021-12-12 \u7535\u8bdd\u8bf7\u9aa8\u5916\u79d1\u4f1a\u8bca\uff1a\u5efa\u8bae\u5148\u5b8c\u5584\u9888\u690eDR\u3001MRI\u540e\u518d\u4f1a\u8bca<\/p>\n
\u00b7 2021-12-12 \u653e\u5c04\u9888\u690e\u6b63\u4fa7\u4f4dDR \uff1a\u9888\u690e\u9000\u884c\u6027\u53d8\uff0c\u98884\u30016\u690e\u4f53\u9aa8\u8d28\u5bc6\u5ea6\u4e0d\u5747\u5300\uff0c\u5efa\u8bae\u884c\u9888\u690eMRI\u68c0\u67e5 \u00b7 2021-12-14 MRI-\u9888\u690e\u5e73\u626b\uff1a1.\u9888\u690e\u9000\u884c\u6027\u53d8\uff1b\u98883-4\u690e\u4f53\u5931\u7a33\uff1b2.\u98884-6\u690e\u4f53\u76f8\u5bf9\u7f18\u7ec8\u677f\u8f6f\u9aa8\u708e<\/p>\n
\u00b7 \u8bf7\u9aa8\u5916\u79d1\u4f1a\u8bca\uff0c\u8003\u8651\u708e\u6027\u53ef\u80fd\u6027\u5927<\/p>\n
\u00b7 \u8003\u8651\u60a3\u8005\u5f71\u50cf\u5b66\u8868\u73b0\u975e\u5e38\u503e\u5411\u4e8eSAPHO\u7efc\u5408\u5f81\uff0c\u5efa\u8bae\u60a3\u8005\u5c31\u8bca\u540c\u6d4e\u9aa8\u5916\u79d1\u8fdb\u4e00\u6b65\u786e\u8bca<\/p>\n
\u00b7 \u60a3\u8005\u643a\u5e26\u6240\u6709\u8fd1\u671f\u68c0\u67e5\u8d44\u6599\u524d\u5f80\u540c\u6d4e\u533b\u9662\u9aa8\u5916\u79d1\u5c31\u8bca\uff0c\u7ecf\u9aa8\u5916\u79d1\u6768\u6559\u6388\u786e\u8bca\uff0c\u60a3\u8005\u786e\u5b9e\u5c5e\u4e8eSAPHO\u7efc\u5408\u5f81\uff0c\u6682\u65e0\u9700\u7279\u6b8a\u6cbb\u7597\uff0c\u75bc\u75db\u65f6\u4e88\u4ee5\u5bf9\u75c7\u6cbb\u7597\u5373\u53ef<\/p>\n
\u6700\u7ec8\u8bca\u65ad\uff1aSAPHO\u7efc\u5408\u5f81<\/p>\n
\u4e00<\/p>\n
\u75be\u75c5\u4ecb\u7ecd (Introduction)<\/p>\n
\u00b7 1987\u5e74\uff0c\u7531Chamot\u7b49\u9996\u6b21\u63d0\u51faSAPHO\uff0c\u662f5\u79cd\u75be\u75c5\u7684\u9996\u5b57\u6bcd\u7f29\u5199\uff0c\u5305\u62ec\u6ed1\u819c\u708e\uff08Synovitis\uff09\u3001\u75e4\u75ae\uff08Acne\uff09\u3001\u8113\u75b1\u75c5\uff08Pustulosis\uff09\u3001\u9aa8\u8d28\u589e\u751f\u80a5\u539a\uff08Hyperostosis\uff09\u548c\u9aa8\u708e\uff08osteitis\uff09<\/p>\n
\u00b7 \u662f\u4e00\u79cd\u4ee5\u76ae\u80a4\u3001\u9aa8\u548c\u5173\u8282\u53d7\u7d2f\u4e3a\u7279\u5f81\u7684\u6162\u6027\u65e0\u83cc\u6027\u708e\u75c7<\/p>\n
\u00b7 \u7f55\u89c1\uff0c\u53d1\u75c5\u7387\u4e3a\u4e07\u5206\u4e4b\u4e00\u3002\u4e3b\u8981\u5f71\u54cd\u513f\u7ae5\u548c\u6210\u4eba\uff0c\u65e0\u6027\u522b\u5dee\u5f02<\/p>\n
\u00b7 \u75c5\u56e0\u4e0d\u660e<\/p>\n
\u00b7 \u53ef\u80fd\u4e0e\u611f\u67d3\u3001\u81ea\u8eab\u514d\u75ab\u53ca\u9057\u4f20\u76f8\u5173<\/p>\n
\u00b7 \u6709\u5b66\u8005\u8ba4\u4e3a\u672c\u75c5\u53ef\u4ee5\u5f52\u7eb3\u5728\u8840\u6e05\u9634\u6027\u810a\u67f1\u5173\u8282\u75c5\u8303\u7574\uff0c\u662f\u4ecb\u4e8e\u5f3a\u76f4\u6027\u810a\u67f1\u708e\uff08AS\uff09\u4e0e\u94f6\u5c51\u75c5\u5173\u8282\u708e\uff08PsA\uff09\u4e4b\u95f4\u7684\u75be\u75c5<\/p>\n
\u00b7 8%\u75c5\u4f8bHLA-B27 \u9633\u6027<\/p>\n
\u00b7 Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome represents a group of diseases characterized by a combination of osteoarthritic inflammation and sterile pustular skin disease . Chamot et al. described 85 patients and coined the term ‘SAPHO’ in 1987<\/p>\n
\u00b7 SAPHO is a rare disorder that affects predominantly children and adults.The estimated prevalence is 1 in 10,000.There is no predilection for gender<\/p>\n
\u00b7 Although the pathogenesis of SAPHO is not yet understood, one may consider that infectious, immunologic, and genetic factors are involved in it<\/p>\n
\u00b7 Human leukocyte antigen (HLA) B27 was positive in 8% of the patients<\/p>\n
Scroll down for more<\/p>\n
\u4e8c<\/p>\n
\u4e34\u5e8a\u8868\u73b0 (Clinical presentation)<\/p>\n
\u00b7 \u4e34\u5e8a\u8868\u73b0\u5305\u62ec\u60a3\u5904\u75bc\u75db\u3001\u538b\u75db\u3001\u80bf\u80c0\u548c\u53d1\u70ed\uff0c\u6ed1\u819c\u708e\u548c\u5173\u8282\u75c5<\/p>\n
\u00b7 \u76ae\u80a4\u75c5\u53d8\uff1a\u75e4\u75ae\u53ca\u638c\u8dd6\u8113\u75b1\u75c5<\/p>\n
\u00b7 \u8d85\u8fc7 90% \u7684 SAPHO \u75c5\u4f8b\u62a5\u544a\u6709\u9aa8\u5173\u8282\u708e\uff1a\u9aa8\u786c\u5316\u548c\u9aa8\u80a5\u539a\uff08\u7279\u5f81\u6027\uff09<\/p>\n
\u00b7 \u6700\u5e38\u89c1\u4e8e\u524d\u80f8\u58c1\uff08\u80f8\u9501\u3001\u80f8\u808b\u5173\u8282\u3001\u808b\u8f6f\u9aa8\u5173\u8282\uff09\uff0c\u5176\u6b21\u662f\u810a\u67f1\uff0c\u9ab6\u9ac2\u5173\u8282\u548c\u957f\u9aa8<\/p>\n
\u00b7 Symptoms include pain in the affected part, osteitis accompanied by tenderness, swelling and fever, synovitis, and arthropathy. Osteoarthritis is reported in over 90% of SAPHO cases (sternocostoclavicular region, 65\u201390%; spine, 32\u201352%; pelvis, 13\u201352%; long bones, 30%; mandible, 11%)<\/p>\n
CASE<\/p>\n
\u4e09<\/p>\n
\u75be\u75c5\u8bca\u65ad(Diagnosis)<\/p>\n
2003\u5e74\u8bca\u65ad\u6807\u51c6\uff1a<\/p>\n
\u00b7 \u9aa8\u548c\uff08\u6216\uff09\u5173\u8282\u75c5\u4f34\u6709\u638c\u8dd6\u8113\u75b1\u75c5<\/p>\n
\u00b7 \u9aa8\u548c\uff08\u6216\uff09\u5173\u8282\u75c5\u4f34\u6709\u4e25\u91cd\u578b\u5ea7\u75ae<\/p>\n
\u00b7 \u6210\u4eba\u5b64\u7acb\u7684\u65e0\u83cc\u7684\u9aa8\u80a5\u539a\u6216\u9aa8\u708e\uff08\u75e4\u75ae\u4e19\u9178\u6746\u83cc\u9664\u5916\uff09<\/p>\n
\u00b7 \u513f\u7ae5\u6162\u6027\u590d\u53d1\u6027\u591a\u7076\u6027\u9aa8\u9ad3\u708e<\/p>\n
\u00b7 \u4e0e\u6162\u6027\u80a0\u75c5\u76f8\u5173\u7684\u9aa8\u5173\u8282\u53d7\u7d2f<\/p>\n
* \u7b26\u5408\u4ee5\u4e0a5\u4e2a\u6761\u4ef6\u4e4b\u4e00\uff0c\u5373\u53ef\u8bca\u65ad<\/p>\n
\u56db<\/p>\n
\u6cbb\u7597\u4e0e\u9884\u540e(Treatment and prognosis)<\/p>\n
\u00b7 \u826f\u6027\u81ea\u9650\u6027\u75be\u75c5\uff0c\u65e0\u6cbb\u7597\u5171\u8bc6<\/p>\n
\u00b7 \u591a\u91c7\u7528\u975e\u753e\u4f53\u6297\u708e\u836f\u548c\u9547\u75db\u836f\uff1b\u76ae\u8d28\u7c7b\u56fa\u9187\uff0c\u6539\u5584\u75be\u75c5\u7684\u6297\u98ce\u6e7f\u836f\u7269<\/p>\n
\u00b7 \u9884\u540e\u826f\u597d<\/p>\n
\u00b7 Current treatments for SAPHO syndrome include nonsteroidal anti-inflammatory drugs and analgesics<\/p>\n
\u00b7 Systemic corticosteroids, disease-modifying anti-rheumatic drugs, biological targeting tumor necrosis factor alpha and interleukin-1 and bisphosphonates have been reported to be beneficial in SAPHO syndrome<\/p>\n
\u4e94<\/p>\n
\u5f71\u50cf\u7279\u5f81(Radiographic features)<\/p>\n
\u00b7 X\u7ebf\u2014\u690e\u4f53\u8fb9\u7f18\u89d2\u7684\u75c5\u53d8\uff1a\u88ab\u8ba4\u4e3a\u662fSAPHO\u7efc\u5408\u5f81\u7684\u4e3b\u8981\u6539\u53d8\uff0c\u5448\u5c40\u7076\u6027\u4fb5\u8680\u548c\/\u6216\u786c\u5316<\/p>\n
\u00b7 CT \u2014\u9aa8\u4fb5\u8680\u3001\u5173\u8282\u95f4\u9699\u53d8\u7a84\u3001\u97e7\u5e26\u9aa8\u5316\u3001\u8f6f\u9aa8\u4e0b\u786c\u5316\u548c\u9aa8\u819c\u9aa8\u5f62\u6210<\/p>\n
\u00b7 MRI\u2014\u5728T2WI\u6216STIR\u4e0a\u89c2\u5bdf\u5230\u690e\u4f53\u524d\u90e8\u5c40\u90e8\u5448\u9ad8\u4fe1\u53f7\uff1a\u7d2f\u53ca\u591a\u4e2a\u690e\u4f53\u3001\u7279\u5f02\u6027\u810a\u690e\u708e\u3001\u6eb6\u9aa8\u6027\u6539\u53d8\u3001\u9aa8\u786c\u5316\u3001\u690e\u65c1\u75c5\u53d8\u7684\u9aa8\u5316\u3001\u9ab6\u9ac2\u5173\u8282\u708e<\/p>\n
\u00b7 ECT\u2014 \u725b\u5934\u5f81\uff1a\u6838\u7d20\u626b\u63cf\u8868\u73b0\u4e3a\u524d\u4e0a\u80f8\u58c1\u9aa8\u8d28\u5f02\u5e38\u653e\u5c04\u6027\u6838\u7d20\u6d53\u805a\uff0c\u5448\u73b0\u201c\u725b\u89d2\u201d\u7684\u5f62\u72b6\uff0820%\uff09<\/p>\n
\u00b7 \u5e94\u7279\u522b\u6ce8\u610f\u810a\u67f1\u68c0\u67e5\uff0c\u6709\u52a9\u4e8e\u65e9\u671f\u8bca\u65ad\u5e76\u9632\u6b62\u6d3b\u68c0\u4e0d\u5f53\u548c\u4e0d\u5fc5\u8981\u7684\u624b\u672f<\/p>\n
\u00b7 Two important osteoarticular manifestations are hyperostosis and osteitis, which are chronic inflammatory reactions involving the cortical and medullary bone<\/p>\n
\u00b7 Spinal involvement has a variety of forms, including vertebral hyperostosis; osteolytic lesions with vertebral collapse; spondylitis with or without discitis; paravertebral ossifications and further syndesmophytes; and sacroiliitis<\/p>\n
\u00b7 CT examination can show cortical bone erosions, joint-space narrowing, ligament ossification, subchondral sclerosis, and periosteal bone formation<\/p>\n
\u00b7 This bull\u2019s head appearance has been considered one of the characteristics of SAPHO<\/p>\n
\u00b7 Special attention should be given to examination of the spine, which can facilitate an early diagnosis and prevent inadequate biopsies and unnecessary surgery<\/p>\n
CASE 1<\/p>\n
\u7537\uff0c53\u5c81\uff0c\u524d\u80f8\u58c1\u75bc\u75db\u2193<\/p>\n
\u00b7 b: \u53cc\u4fa7\u80f8\u808b\u9501\u5173\u8282\u548c\u80f8\u9aa8\u67c4\u201c\u725b\u5934\u201d\u5f81<\/p>\n
\u00b7 c\u3001d: \u9ab6\u9aa8\u53f3\u4fa7\u548c\u53cc\u4fa7\u9ab6\u9ac2\u5173\u8282\u5468\u56f4\u5f02\u5e38\u4fe1\u53f7\uff0c\u63d0\u793a\u9ab6\u9ac2\u5173\u8282\u708e\u548c\u9aa8\u9ad3\u6c34\u80bf<\/p>\n
\u00b7 \u638c\u8dd6\u8113\u75b1\u75c5+\u5173\u8282\u708e<\/p>\n
\u2014\u2014\u8bca\u65ad\uff1aSAPHO<\/p>\n
CASE 2<\/p>\n
2a\uff1a\u80f8\u9501\u5173\u8282\u3001\u53f3\u80b1\u9aa8\u8fdc\u7aef\u3001\u53f3\u6861\u9aa8\u548c\u5c3a\u9aa8\u8fd1\u7aef\u3001\u8153\u9aa8\u548c\u80eb\u9aa8\u6838\u7d20\u6444\u53d6\u589e\u52a0<\/p>\n
2b\uff1a\u53cc\u4fa7\u7b2c\u4e00\u524d\u808b\u9aa8\u80a5\u539a<\/p>\n
2c\uff1a\u53f3\u80b1\u9aa8\u3001\u6861\u9aa8\u9aa8\u786c\u5316\uff0c\u53f3\u5c3a\u9aa8\u660e\u663e\u9aa8\u786c\u5316\u548c\u9aa8\u8d28\u589e\u751f<\/p>\n
2d\uff1a\u53cc\u4fa7\u80eb\u8153\u9aa8\u9aa8\u786c\u5316\u548c\u9aa8\u8d28\u589e\u751f<\/p>\n
\u7537\uff0c55\u5c81\uff0c\u53f3\u8098\u75bc\u75db\u548c\u80bf\u80c0\u2193<\/p>\n
3a: \u53cc\u4fa7\u9501\u9aa8\u5185\u4fa7\u7aef\u548c\u80f8\u9aa8\u67c4\u9aa8\u786c\u5316\u548c\u9aa8\u4fb5\u8680<\/p>\n
3c: \u80f8\u690e\u4f53\u690e\u65c1\u9aa8\u8d28\u589e\u751f\u548c\u9aa8\u4fb5\u8680<\/p>\n
\u00b7 \u540c\u4e0a\u4e2a\u75c5\u4eba<\/p>\n
\u00b7 \u53f3\u80b1\u9aa8\u3001\u5c3a\u6861\u9aa8\u9aa8\u76ae\u8d28\u589e\u539a\uff0c\u9aa8\u819c\u4fe1\u53f7\u5f02\u5e38\u3001\u9aa8\u9ad3\u6c34\u80bf<\/p>\n
CASE 3<\/p>\n
\u00b7 The classical osteitis of SAPHO syndrome<\/p>\n
\u00b7 MRI of lumbar spine (T1, T2, STIR, sagital imaging)<\/p>\n
\u00b7 Anterior syndesmophytes from L3 to L5 (arrows), with bone marrow edema in the anterior segments of L2, L3, and L5 (arrow heads)<\/p>\n
\u516d<\/p>\n
\u9274\u522b\u8bca\u65ad (Differential diagnosis)<\/p>\n
\u00b7 \u5f3a\u76f4\u6027\u810a\u67f1\u708e\uff1a\u7d2f\u53ca\u9ab6\u9ac2\u5173\u8282\uff0c\u5173\u8282\u9762\u7834\u574f\uff0c\u5173\u8282\u95f4\u9699\u72ed\u7a84\uff0c\u7136\u540e\u7531\u4e0b\u5411\u4e0a\u53d1\u5c55\u81f3\u5168\u810a\u67f1\uff0c\u690e\u4f53\u53d8\u65b9\u6b63\uff0c\u4ee5\u9aa8\u8d28\u758f\u677e\u4e3a\u4e3b\uff0c\u201c\u7af9\u8282\u5f81\u201d\uff0c\u4f46\u5f88\u5c11\u7d2f\u53ca\u524d\u4e0a\u80f8\u58c1\uff0c\u4e00\u822c\u65e0\u80f8\u808b\u9501\u5173\u8282\u9aa8\u5316\u3002HLA-B27\u5448\u9633\u6027\uff0c\u65e0\u76ae\u80a4\u635f\u5bb3<\/p>\n
\u00b7 \u9aa8\u611f\u67d3\u6027\u75c5\u53d8: \u9aa8\u8d28\u7834\u574f\u533a\u5185\u53ef\u89c1\u6b7b\u9aa8\uff0c\u5e38\u4f34\u6709\u9aa8\u5185\u53ca\u5468\u56f4\u8f6f\u7ec4\u7ec7\u8113\u80bf\uff0c\u4e2d\u8f74\u9aa8\u611f\u67d3\u4e0d\u4f1a\u51fa\u73b0\u4e24\u4fa7\u5bf9\u79f0\u6027\u6539\u53d8<\/p>\n
\u00b7 \u810a\u67f1\u8f6c\u79fb\u6027\u80bf\u7624: \u9aa8\u8d28\u7834\u574f\u5e38\u7d2f\u53ca\u690e\u4f53\u9644\u4ef6\uff0c\u4f34\u8f6f\u7ec4\u7ec7\u80bf\u5757\uff0c\u591a\u6709\u80bf\u7624\u75c5\u53f2<\/p>\n
\u603b\u7ed3(Conclusion)<\/p>\n
\u5f53\u60a3\u8005\u51fa\u73b0\u6301\u7eed\u7684\u9aa8\u5173\u8282\u75c5\u53d8\u548c(\u6216)\u4ee5\u638c\u8dd6\u8113\u75b1\u75c5\u53ca\u75e4\u75ae\u6837\u6539\u53d8\u4e3a\u4e3b\u7684\u76ae\u80a4\u75c5\u65f6\uff0c\u5e94\u8003\u8651\u5230SAPHO\u7efc\u5408\u5f81\u7684\u53ef\u80fd<\/p>\n
\u4f5c\u8005<\/p>\n
\u533b\u9662\u540d\u79f0\uff1a\u6b66\u6c49\u5927\u5b66\u4eba\u6c11\u533b\u9662\u653e\u5c04\u79d1<\/p>\n
\u4e3b\u6cbb\u533b\u5e08\uff1a\u5218\u82b3<\/p>\n
\u6765\u6e90<\/p>\n
\u90fd\u53f8\u5f71\u50cf\u516c\u4f17\u53f7\u4e3a\u6b66\u6c49\u5927\u5b66\u4eba\u6c11\u533b\u9662\u653e\u5c04\u79d1\u5b98\u65b9\u5e73\u53f0\uff0c\u4e3b\u8981\u5c55\u793a\u79d1\u5ba4\u7279\u8272\u8bca\u7597\u6280\u672f\u3001\u7cbe\u9009\u4e13\u9898\u8bb2\u5ea7\u3001\u7ecf\u5178\u4e34\u5e8a\u75c5\u4f8b\u3001\u79d1\u7814\u56e2\u961f\u6700\u65b0\u6210\u679c\uff1b\u517c\u5177\u79d1\u5ba4\u6559\u7814\u52a8\u6001\u3001\u4f1a\u8bae\u4fe1\u606f\u53d1\u5e03\u529f\u80fd\u3002<\/p>\n
\u4f18\u7ef4\u663e\u00ae370 Ultravist\u00ae370<\/p>\n
\u7b80\u660e\u5904\u65b9<\/p>\n
\u5728\u4f7f\u7528\u524d\u5e94\u8be5\u5bf9\u5bf9\u6bd4\u5242\u8fdb\u884c\u76ee\u89c6\u68c0\u67e5\uff0c\u4e0d\u5f97\u4f7f\u7528\u53d8\u8272\u3001\u5b58\u5728\u9897\u7c92\u7269\u8d28\uff08\u5305\u62ec\u7ed3\u6676\uff09\u6216\u5bb9\u5668\u5b58\u5728\u7834\u635f\u7684\u5bf9\u6bd4\u5242\u3002<\/p>\n
\u3010\u836f\u54c1\u540d\u79f0\u3011<\/p>\n
\u901a\u7528\u540d\u79f0: \u7898\u666e\u7f57\u80fa\u6ce8\u5c04\u6db2<\/p>\n
\u5546\u54c1\u540d\u79f0: \u4f18\u7ef4\u663e\u00ae Ultravist\u00ae<\/p>\n
\u82f1\u6587\u540d\u79f0: Iopromide Injection<\/p>\n
\u3010\u6210\u4efd\u3011\u672c\u54c1\u6d3b\u6027\u6210\u4efd\u4e3a\u7898\u666e\u7f57\u80fa<\/p>\n
\u3010\u9002\u5e94\u75c7\u3011\u7528\u4e8e\u8bca\u65ad\u7528\u836f\u3002\u7898\u666e\u7f57\u80fa\u6ce8\u5c04\u6db2300\/370 \u7528\u4e8e\u8ba1\u7b97\u673aX\u7ebf\u4f53\u5c42\u626b\u63cf(CT)\u589e\u5f3a\uff0c\u52a8\u8109\u9020\u5f71\u548c\u9759\u8109\u9020\u5f71\uff0c\u52a8\u8109\u6cd5\/\u9759\u8109\u6cd5\u6570\u5b57\u51cf\u5f71\u8840\u7ba1\u9020\u5f71(DSA)\uff0c\u9759\u8109\u5c3f\u8def\u9020\u5f71\uff0c\u5185\u7aa5\u955c\u9006\u884c\u80f0\u80c6\u7ba1\u9020\u5f71(ERCP)\uff0c\u5173\u8282\u8154\u9020\u5f71\u548c\u5176\u4ed6\u4f53\u8154\u68c0\u67e5\u3002\u7898\u666e\u7f57\u80fa\u6ce8\u5c04\u6db2370 \u7279\u522b\u9002\u7528\u4e8e\u5fc3\u8840\u7ba1\u9020\u5f71\u3002<\/p>\n
\u3010\u7528\u6cd5\u7528\u91cf\u3011\u7898\u666e\u7f57\u80fa\u6ce8\u5c04\u6db2300\/370 \u7528\u4e8e\u8840\u7ba1\u5185\u548c\u4f53\u8154\u5185\uff0c\u4e0d\u80fd\u5728\u9798\u5185\u4f7f\u7528\u3002\u5242\u91cf\u5e94\u4f9d\u636e\u5e74\u9f84\uff0c\u4f53\u91cd\uff0c\u4e34\u5e8a\u60c5\u51b5\u548c\u68c0\u67e5\u6280\u672f\u6765\u8fdb\u884c\u8c03\u6574\u3002\u8be6\u89c1\u8bf4\u660e\u4e66\u3002<\/p>\n
\u3010\u4e0d\u826f\u53cd\u5e94\u3011\u6700\u5e38\u89c1\u5934\u75db\u3001\u6076\u5fc3\u548c\u8840\u7ba1\u6269\u5f20\u3002\u4f7f\u7528\u672c\u54c1\u7684\u60a3\u8005\u4e2d\u53d1\u751f\u7684\u6700\u4e25\u91cd\u7684\u836f\u7269\u4e0d\u826f\u53cd\u5e94\uff08\u5728\u4e34\u5e8a\u8bd5\u9a8c\u6216\u4e0a\u5e02\u540e\u76d1\u6d4b\u8fc7\u7a0b\u4e2d\u5df2\u6709\u5a01\u80c1\u751f\u547d\u548c\/\u6216\u81f4\u6b7b\u6027\u75c5\u4f8b\u62a5\u544a\u7684\uff09\u5305\u62ec\uff1a\u7c7b\u8fc7\u654f\u6027\u4f11\u514b\u3001\u547c\u5438\u505c\u6b62\u3001\u652f\u6c14\u7ba1\u75c9\u631b\u3001\u5589\u6c34\u80bf\u3001\u54bd\u90e8\u6c34\u80bf\u3001\u54ee\u5598\u3001\u660f\u8ff7\u3001\u5927\u8111\u6897\u6b7b\u3001\u5352\u4e2d\u3001\u8111\u6c34\u80bf\u3001\u60ca\u53a5\u3001\u5fc3\u5f8b\u5931\u5e38\u3001\u5fc3\u810f\u505c\u640f\u3001\u5fc3\u808c\u7f3a\u8840\u3001\u5fc3\u808c\u6897\u6b7b\u3001\u5fc3\u529b\u8870\u7aed\u3001\u5fc3\u52a8\u8fc7\u7f13\u3001\u53d1\u7ec0\u3001\u4f4e\u8840\u538b\u3001\u4f11\u514b\u3001\u547c\u5438\u56f0\u96be\u3001\u80ba\u6c34\u80bf\u3001\u547c\u5438\u529f\u80fd\u4e0d\u5168\u548c\u8bef\u5438\u3002\u9664\u4e86\u4e0a\u9762\u5217\u51fa\u7684\u4e0d\u826f\u53cd\u5e94\u4ee5\u5916\uff0c\u9798\u5185\u4f7f\u7528\u65f6\u66fe\u62a5\u544a\uff1a\u5316\u5b66\u6027\u8111\u819c\u708e\u548c\u5047\u6027\u8111\u819c\u708e\uff08\u9891\u7387\u4e0d\u660e\uff09\uff1b\u7528\u4e8eERCP\u68c0\u67e5\u65f6\u62a5\u544a\uff1a\u80f0\u9176\u6c34\u5e73\u5347\u9ad8\u548c\u80f0\u817a\u708e\uff08\u9891\u7387\u4e0d\u660e\uff09\uff1b\u810a\u9ad3\u6216\u4f53\u8154\u9020\u5f71\u540e\u53d1\u751f\u7684\u4e0d\u826f\u53cd\u5e94\u5927\u90e8\u5206\u51fa\u73b0\u5728\u7ed9\u836f\u540e\u6570\u5c0f\u65f6\u5185\u3002\u8be6\u89c1\u8bf4\u660e\u4e66\u3002<\/p>\n
\u3010\u7981\u5fcc\u3011\u5bf9\u542b\u7898\u5bf9\u6bd4\u5242\u8fc7\u654f\u53ca\u660e\u663e\u7684\u7532\u72b6\u817a\u529f\u80fd\u4ea2\u8fdb\u7684\u60a3\u8005\u7981\u7528\u3002\u598a\u5a20\u53ca\u6025\u6027\u76c6\u8154\u708e\u60a3\u8005\u7981\u884c\u5b50\u5bab\u8f93\u5375\u7ba1\u9020\u5f71\u3002\u6025\u6027\u80f0\u817a\u708e\u65f6, \u7981\u884cERCP (\u5185\u7aa5\u955c\u9006\u884c\u6027\u80f0\u80c6\u7ba1\u9020\u5f71)\u3002<\/p>\n
\u7981\u7528\u4e8e\u9798\u5185\u6ce8\u5c04\u3002\u9798\u5185\u7ed9\u836f\u4e5f\u8bb8\u4f1a\u5bfc\u81f4\u6b7b\u4ea1\u3001\u60ca\u53a5\u3001\u8111\u51fa\u8840\u3001\u660f\u8ff7\u3001\u762b\u75ea\u3001\u86db\u7f51\u819c\u708e\u3001\u6025\u6027\u80be\u529f\u80fd\u8870\u7aed\u3001\u5fc3\u810f\u9aa4\u505c\u3001\u62bd\u6410\u3001\u6a2a\u7eb9\u808c\u6eb6\u89e3\u75c7\u3001\u9ad8\u70ed\u548c\u8111\u6c34\u80bf\u3001\u5316\u5b66\u6027\u8111\u819c\u708e\u3001\u5047\u6027\u8111\u819c\u708e\u3002<\/p>\n
\u3010\u6ce8\u610f\u4e8b\u9879\u3011\u5bf9\u4e8e\u6240\u6709\u7684\u9002\u5e94\u75c7\uff0c\u8840\u7ba1\u5185\u4f7f\u7528\u65f6\u5371\u9669\u6027\u8f83\u9ad8\u3002<\/p>\n
\u5bf9\u4e8e\u5df2\u77e5\u5bf9\u7898\u666e\u7f57\u80fa\u6ce8\u5c04\u6db2\u6216\u5176\u8f85\u6599\u8fc7\u654f\u6216\u5148\u524d\u5bf9\u4efb\u4f55\u5176\u4ed6\u542b\u7898\u5bf9\u6bd4\u5242\u8fc7\u654f\u7684\u60a3\u8005\uff0c\u7532\u72b6\u817a\u529f\u80fd\u4e0d\u5168\u7684\u60a3\u8005\uff0c\u8001\u5e74\u4eba\u548c\u8eab\u4f53\u72b6\u51b5\u5f88\u5dee\u7684\u60a3\u8005\u9700\u8fdb\u884c\u7279\u522b\u8c28\u614e\u7684\u98ce\u9669\/\u6536\u76ca\u8bc4\u4f30\u3002\u5728\u5148\u524d\u5bf9\u5bf9\u6bd4\u5242\u6709\u8fc7\u654f\u53cd\u5e94\uff0c\u6709\u652f\u6c14\u7ba1\u54ee\u5598\u53f2\u6216\u5176\u4ed6\u8fc7\u654f\u53f2\u7684\u60a3\u8005\u4e2d\u5371\u9669\u6027\u66f4\u9ad8\u3002\u5efa\u8bae\u7ed9\u836f\u540e\u5bf9\u75c5\u4eba\u8fdb\u884c\u89c2\u5bdf\uff0c\u7d27\u6025\u63aa\u65bd\u7684\u5efa\u7acb\u5bf9\u6240\u6709\u60a3\u8005\u90fd\u662f\u5fc5\u8981\u7684\u3002<\/p>\n
\u4f7f\u7528\u5bf9\u6bd4\u5242\u540e\u53ef\u80fd\u53d1\u751f\u80be\u529f\u80fd\u7684\u6682\u65f6\u6027\u635f\u4f24\uff0c\u5728\u4e00\u4e9b\u75c5\u4f8b\u4e2d\u53ef\u80fd\u53d1\u751f\u6025\u6027\u80be\u529f\u80fd\u8870\u7aed\u3002\u5371\u9669\u56e0\u7d20\u5305\u62ec\uff0c\u5148\u524d\u5b58\u5728\u7684\u80be\u529f\u80fd\u4e0d\u5168\uff0c\u8131\u6c34\uff0c\u7cd6\u5c3f\u75c5\uff0c\u591a\u53d1\u6027\u9aa8\u9ad3\u7624\/\u75c5\u53d8\u86cb\u767d\u8840\u75c7\uff0c\u53cd\u590d\u548c\/\u6216\u5927\u5242\u91cf\u4f7f\u7528\u672c\u54c1\u3002\u8840\u7ba1\u5185\u4f7f\u7528\u5bf9\u6bd4\u5242\u524d\u540e\u5fc5\u987b\u786e\u4fdd\u6240\u6709\u60a3\u8005\u5904\u4e8e\u5145\u5206\u7684\u6c34\u5316\u72b6\u6001\u3010\u5927\u591a\u6570\u60a3\u8005\u53ef\u4ee5\u6839\u636e\u9700\u8981\u901a\u8fc7\u53e3\u670d\u8865\u6db2\u6765\u8fbe\u5230\u5145\u5206\u7684\u6c34\u5316\u72b6\u6001\u3002\u5173\u4e8e\u54ea\u4e9b\u60a3\u8005\u9700\u8981\u9884\u9632\u6027\u9759\u8109\u6c34\u5316\u7684\u51b3\u5b9a\u5e94\u57fa\u4e8e\u6700\u65b0\u7684\u5faa\u8bc1\u4e34\u5e8a\u6307\u5357\u7684\u5efa\u8bae\u4ee5\u53ca\u4e2a\u4f53\u83b7\u76ca-\u98ce\u9669\u6bd4\u3002\u8fd9\u5e94\u5305\u62ec\u8003\u8651\u4f7f\u7528\u7684\u5242\u91cf\uff08\u4f8b\u5982\u9ad8\u5242\u91cf\uff09\u3001\u7ed9\u836f\u9014\u5f84\uff08\u201c\u9996\u8fc7\u201d\u66b4\u9732\uff09\u548c\u80be\u529f\u80fd\uff08\u4e25\u91cd\u80be\u529f\u80fd\u8870\u7aed\u7684\u5b58\u5728\uff09\u3011\u3002\u63a8\u8fdf\u65b0\u7684\u5bf9\u6bd4\u5242\u68c0\u67e5\uff0c\u76f4\u81f3\u80be\u529f\u80fd\u6062\u590d\u5230\u68c0\u67e5\u524d\u7684\u6c34\u5e73\u3002<\/p>\n
\u5bf9\u4e8e\u60a3\u6709\u4e25\u91cd\u7684\u5fc3\u810f\u75be\u75c5\u548c\u91cd\u5ea6\u7684\u51a0\u72b6\u52a8\u8109\u75be\u75c5\u7684\u60a3\u8005\uff0c\u4e34\u5e8a\u76f8\u5173\u7684\u8840\u6db2\u52a8\u529b\u5b66\u6539\u53d8\u548c\u5fc3\u5f8b\u5931\u5e38\u7684\u5371\u9669\u6027\u589e\u52a0\u3002<\/p>\n
\u8840\u7ba1\u5185\u4f7f\u7528<\/p>\n
\u6709\u4e2d\u67a2\u795e\u7ecf\u7cfb\u7edf\uff08CNS\uff09\u5f02\u5e38\u7684\u60a3\u8005\u53d1\u751f\u5e76\u53d1\u75c7\u7684\u98ce\u9669\u53ef\u80fd\u589e\u52a0\u3002\u55dc\u94ec\u7ec6\u80de\u7624\u60a3\u8005\u6709\u53d1\u751f\u9ad8\u8840\u538b\u5371\u8c61\u7684\u98ce\u9669\u3002\u5176\u4ed6\u5982\u5728\u81ea\u8eab\u514d\u75ab\u75be\u75c5\u7684\u60a3\u8005\u3001\u91cd\u75c7\u808c\u65e0\u529b\u3001\u9152\u7cbe\u4e2d\u6bd2\u60a3\u8005\u4e2d\u4f7f\u7528\u98ce\u9669\u6027\u589e\u52a0\u3002<\/p>\n
\u4f53\u8154\u5185\u7684\u4f7f\u7528<\/p>\n
\u8fdb\u884c\u5b50\u5bab\u8f93\u5375\u7ba1\u9020\u5f71\u524d\uff0c\u5fc5\u987b\u9664\u5916\u598a\u5a20\u7684\u53ef\u80fd\u6027\u3002\u80c6\u7ba1\u6216\u8f93\u5375\u7ba1\u708e\u75c7\u53ef\u4ee5\u589e\u52a0\u68c0\u67e5\u540e\u53d1\u751f\u4e0d\u826f\u53cd\u5e94\u7684\u5371\u9669\u6027\u3002<\/p>\n
\u8be6\u89c1\u8bf4\u660e\u4e66\u3002<\/p>\n
\u3010\u836f\u7269\u5206\u7c7b\u3011\u5904\u65b9\u836f<\/p>\n
\u3010\u836f\u54c1\u4e0a\u5e02\u8bb8\u53ef\u6301\u6709\u4eba\u3011Bayer Vital GmbH<\/p>\n
\u3010\u751f\u4ea7\u4f01\u4e1a\u3011<\/p>\n
\u4f01\u4e1a\u540d\u79f0\uff1aBayer AG<\/p>\n
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1. Hidetomo Himuro, Seiji Kurata, et al. Imaging features in patients with SAPHO\/CRMO: a pictorial review.Jpn J Radiol. 2020 Jul;38(7):622-629<\/p>\n
2. Sueli Carneiro, Percival D Sampaio-Barros, et al. SAPHO syndrome. Rheum Dis Clin N Am. 39 (2013) 401\u2013418<\/p>\n
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