【摘要】 目的　了解Reiter’s综合征 (RS)的临床表现 ,实验室改变和预后变化。方法　对近 6年收治的2 9例患者进行临床分析 ,并随访本病预后。结果　 2 9例患者发病诱因主要是不洁饮食 (17例 )或性交 (2例 )所致的急慢性肠道和泌尿生殖系统炎症。关节痛多以急性非对称性发作 ,易累及膝关节 (2 5 /2 9)、踝关节 (14/2 9)等下肢关节。衣原体和支原体检查有助于发现隐匿的泌尿生殖系统感染 ,提高了本病的确诊率。RS的诊断主要依靠病史和症状 ;而治疗多为经验性 ,急性期常用非甾体消炎药 (2 8/2 9)和中小剂量皮质激素 (19/2 9) ,柳氮磺胺吡啶 (18/2 9)和氨甲喋呤 (3/2 9)用于关节炎为主患者。 15例随访结果表明 ,有 2例复发 ,10例遗留有不同程度的关节或眼部症状。结论　RS是一个表现复杂 ,缺少有效治疗手段 ,预后并非良好的风湿病 ;对RS患者须尽早制定个体化治疗策略 ,并加强饮食及性行为的健康教育。更多还原

【Abstract】 Objective To understand the clinical manifestations, the laboratory data and prognosis of Reiter’s syndrome (RS) in China. Methods Twenty nine cases of RS patients in our hospital over past 6 years had been analyzed. Prognosis had been studied upon follow up visit. Results Eighteen patients were male, and 11 female. Most of them were young and middle aged. Acute and chronic bowel and urinogenital inflammation caused by unsanitary diet(17/29) and sexual intercourse(2/29)were the major incentives of RS. The onset was acute, usually with asymmetric oligoarthritis. Joints of lower limbs such as knees (25/29) and ankles (14/29) were most frequently evolved. Infection in genito urinary system was usually well concealed, therefore, testing on chlamydia and mycoplasma was very helpful both in diagnosis and treatment. The current therapy was empirical. NASIDs(28/29) and steroid(19/29) were mainly prescribed in acute phase; while arthritis was treated with SASP(18/29) and MTX(3/29) . Effect of antibiotics was disputable. The follow up of 15 patients indicated that relapse occurred in 2 cases triggerd by the same incentives. Ten of them had persistent arthritis symptom or eye involvement. Conclusion In order to improve the prognosis and reduce the possibility of relapse, it is necessary to formulate long term therapeutic strategy on a case by case basis, and strengthen the health education in respect of sexual behavior and dietary hygiene.更多还原