复发性多软骨炎的诊断和治疗现状

(510120)[]1(relapsingpolychondritis,RP),,,,,,,2,RP,,,,C3,RP,[1]RP(cartilageoligomericmatrixprotein,COMP)Matrilin21Ma2trilin21,RP,Matrilin21RP[2],RP(humanleukocyteantigen,HLA)2DR4,(majrhistocompatibilitycomplex,MHC)2TRP3RP3060,47,,,RP,(),,,,,;311RP,1,,,,RP,1(%)MCADAM(1976)159MICHET(1986)112TRENTHAM(1998)6633741(26)44(39)60(91)145(43)36(23)40(36)31(47)107(32)22(14)46(41)1)25(38)93(28)21(13)27(24)22(33)70(21)-22(20)-22(7)22(14)21(19)16(24)59(18)-20(18)020(6)10(6)15(13)8(12)33(10)-8(7)08(2)1)26%,15%1/3RP,RP,,,1228%RP,RP,,[,,(),,],RPRP312RP,,,,40%7672007113811RP[3];,,,31372%RP,RP,,314RP,,RP,RP,(),,,,,,,,,,,,CT,RP,,RP,CT,RP,RP[3],,,315,,,,316RP,,30%RP,,,,1/3RP,,,,,,,,,,4,RP,MCADAM(3,2)DAMIANILEVINE,MCADAM3,RP,,(),,,;,,;,,;,,,2MCADAM(1976)33,:;;;;;DAMIANILEVINE(1979)RP:MCADAM3,;MCADAM1,;,()MICHET(1986)32:,,;1,425RP,511()RP,,,1020mg/d,[1mg/(kgd)],,,,1g/d,3,,,(),[4,5]RP8672007113811,,,512RP,,,513RP,,RP,,,RP,,,,;,,,,,514,()CD4(entaner2cept)21(anakinra)RP[6,7],1RP,10mg/d,1g/d6RP,10,,RP1986MICHETRP51074%55%,1998DAVID894%[][1]KRAUSVB,STABLERT,LEET,etal1Urinarytypecollagenneoepitopeasanoutcomemeasureforrelapsingpolychondritis[J]1ArthritisRheum,2003,48(10):2942229481[2]HANSSONAS,JOHANNESSONM,SVENSSONL,etal1Relapsingpolychondritis,inducedinmicewithmatrilin1,isanantibody2andcom2plement2dependentdisease[J]1AmJPathol,2004,64(3):95929661[3],1[J]1,2001,32(7):42824291[4]HANDLERRP1Leflunomideforrelapsingpolychondritis:successfullong2termtreatment[J]1JRheumatol,2006,33(9):1916219171[5]GOLDENBERGG,SANGUEZAOP,JORIZZOJL1Successfultreatmentofrelapsingpolychondritiswithmycophenolatemofetil[J]1JDermatologTreat,2006,17(3):15821591[6]CARTERJD1TreatmentofrelapsingpolychondritiswithaTNFantagonist[J]1JRheumatol,2005,32(7):14131[7]VOUNOTRYPIDISP,SAKELLARIOUGT,ZISOPOULOSD,etal1Re2fractoryrelapsingpolychondritis:rapidandsustainedresponseinthetreat2mentwithanIL21receptorantagonist(anakinra)[J]1Rheumatology(Oxford),2006,45(4):49124921(:2006-12-22)(:)(763),,,,,313,,,1314,HSCT,,,,HSCTHSCT,,,4:21,HSC,HSCT,HSCT;HSCT,,,70%80%,RD2HMTPBSCT,HSCT,20%,(),HSCT,HSCT,,HSCT()(:2007-07-18)(:)9672007113811