风湿性多肌痛47例误诊分析

摘要

目的 探讨风湿性多肌痛( polymyalgia rheumatica,PMR)的临床特点,提高对PMR的认识,减少误诊.方法 回顾性分析我院2006年1月-2011年1月风湿科就诊的47例误诊的PMR的临床资料.结果 47例入院前误诊为多发性肌炎13例(27.7％),腰肌劳损11例(23.4％),上呼吸道感染10例(21.3％),类风湿关节炎8例(17.0％),肩周炎4例(8.5％),纤维肌痛综合征1例(2.1％).根据临床表现结合实验室检查均确诊为PMR,予泼尼松、甲氨蝶呤等治疗后,症状均明显改善.结论 PMR缺乏特异性诊断指标,临床应加强对本病的认识,以提高诊治水平,减少误诊、误治.%Objective To explore clinical characteristics of polymyalgia rheumatica (PMR) in order to improve the awareness of polymyalgia rheumatica and reduce misdiagnosis rate. Methods Clinical data of 47 misdiagnosed patients with polymyalgia rheumatica admitted during January 2006 and January 2011 to our hospital were retrospectively analyzed. Results Among the 47 patients, there were 13 patients (27.7% ) misdiagnosed as having polymyositis, 11 patients (23.4% ) lumbar muscle strain, 10 patients (21.3% ) upper respiratory tract infection, 8 patients (17.0% ) rheumatoid arthritis, 4 patients (8.5% ) periarthritis of shoulder and 1 patient (2.1% ) fibromyalgia syndrome. PMR was finally diagnosed by clinical manifestations and laboratory examinations. The patients' symptoms improved following prednisone and methotrexate therapy. Conclusion Polymyalgia rheumatica has insufficient diagnostic specificity indexes, so clinicians should strengthen awareness of this disease in order to reduce misdiagnosis and mistreatment.