【摘要】 目的 探讨骨髓增生异常综合征( MDS)与自身免疫性疾病的相互关系。方法 对234例MDS患者的临床资料进行分析并随访观察。结果 234例MDS患者中38例并发自身免疫性疾病,占162%;MDS并发自身免疫性疾病以类风湿关节炎(316%)和溃疡性结肠炎(263%)常见;MDS并发自身免疫性疾病者比无自身免疫性疾病者其转白率并不增加,但中位生存期缩短。结论 自身免疫性疾病是MDS预后不良的因素。MDS与自身免疫性疾病可能具有一定的内在关联。
【关键词】 骨髓增生异常综合征;自身免疫性疾病;关联
Clinical observation of the correlationship between myelodysplastic syndrome and autoimmune disease
DENG Fei-qi,TANG Wei.The People’s Hospital of Dongan County,Hunan 425900,China
[Abstract] Objective To investigate the correlationship between myelodysplastic syndrome (MDS) and autoimmune disease.Methods To analyse the clinical materials about the 234 patients with MDS and follow up.Results Among 234 cases,38 patients (16.2%) had complicated with autoimmune diseases,which usually were rheumatoid arthritis (31.6%) and ulcerative colitis (26.3%). The rate of transforming to leucocythemia in MDS patients complicated with autoimmune disease is not more than that in MDS patients without autoimmune disease,but the median lifetime decreased.Conclusion Autoimmune disease is one of the factor that bring out the bad prognosis in MDS.There are probably correlationships between MDS and autoimmune disease.
[Key words] myelodysplastic syndrome;autoimmune disease;correlaitonship
近年来,骨髓增生异常综合征(MDS)与自身免疫性疾病的关系正在引起临床关注,据国外文献报道,与其他恶性肿瘤一样,可以出现各种副瘤免疫现象,如血管炎、关节炎、Grohn’s病,Sueet’s综合征、复发性多软骨炎等,但国内未见此类报道。现对1996年以来经东安县人民医院诊治的234例MDS患者的临床资料进行回顾、随诊,探讨MDS与自身免疫性疾病的相互关系、发病机制、治疗及预后特征。
1 资料与方法
11 一般资料 MDS 234例,男124例,女110例,中位年龄53岁(12~78岁),按FAB协作组织标准诊断和分型,其中反应性关节炎(RA)78例,肾素-血管紧张素-醛固酮系统(RAS)80例,骨髓增生异常综合征原始细胞增多型(RAEB)42例,慢性粒-单核细胞白血病(CMML)17例,原始细胞增多转化型(RAEB-t)17例。
12 方法 (1)所有病例的临床资料、
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