目的报道1例服用甲巯咪唑(商品名赛治)出现抗甲状腺综合征的患者,并进行文献复习。方法对1例30岁女性服用赛治出现抗甲状腺综合征患者的临床资料进行回顾性分析,并复习相关文献。结果本例患者因甲状腺功能亢进症口服赛治(10 mg,tid)治疗,25 d后出现游走性多关节疼痛、活动受限。停用赛治,口服洛索洛芬钠(商品名乐松)治疗,关节疼痛好转。换用丙硫氧嘧啶治疗,无不良反应。结论口服赛治可发生抗甲状腺关节炎综合征,需立即停药。

Objective To report one case of taking thyrozol appears arthritis syndrome patients and a literature review. Methods A 30-year-old female patient with hyperthyroidism appeared arthritis syndrome after starting therapy with the antithyroid drug thyrozol.The patient clinical data were retrospectively analyzed, and review of the literature. Results The patient with hyperthyroidism due to oral thyrozol (10 mg tid) therapy 25 days, her joint happened the migratory joint pain, and limited mobility. Thyrozol was withdrawn.Symptoms disappeared after loxonin was given. Oral therapy was switched to propylthiouracil, no adverse reactions. Conclusion Antithyroid arthritis syndrome can occur when thyrozol therapy for hyperthyroidism. Prompt withdrawal of the antithyroid drug is necessary.

目的：总结系统性红斑狼疮（systemic lupus erythematosus，SLE）合并 Evans 综合征患者的临床特点。方法回顾性分析北京协和医院2004年1月至2012年7月 SLE 合并 Evans 患者的临床表现及实验室特点及治疗和预后。结果 SLE 并发 Evans 综合征患者22例，占同期 SLE 住院患者3400例的0．65％。其中男3例，女19例，平均35．1岁（16～53岁）。22例患者中以血液系统受累[特发性血小板减少性紫癜（idiopathic thrombocytopenic purpura，ITP）或自身免疫性溶血性贫血（autoimmune hemolytic anemia，AIHA）]为首发表现的11例（50％），确诊 SLE 后诊断 Evans 综合征者6例，二者同时诊断的5例。SLE 并发 Evans 综合征时，患者往往有多系统受累，表现为肾脏受累13例（59．1％），皮肤黏膜受累、关节炎各9例（40．9％），神经系统受累4例（18．2％），胃肠道、肺部受累各2例等。Evans 综合征多发生于 SLE 活动期，患者平均狼疮活动指数评分（11．45±7．6）分（3～30分）。伴发其他结缔组织病5例（22．7％）。经激素联合免疫抑制剂治疗后，20例好转，2例无效者应用利妥昔单抗后好转。结论 SLE 合并 Evans 综合征罕见，发生于 SLE 多系统受累及活动期。部分患者以ITP 或 AIHA 为

Objective To analyze the clinical features of Evans syndrome in systemic lupus erythematosus (SLE) patients.Methods Clinical and laboratory manifestations occurring during the disease course,as well as concomitant diseases,treatment and outcomes was carefully reviewed.Results There were 22 SLE patients with Evans Syndrome accounted for 0.65% of the 3 400 hospitalized SLE patients.Nineteen were female and 3 were male,with the mean age of 35.1 year.Evans syndrome was diagnosed prior to SLE in 11 patients,after SLE in 6 patients,and concomitantly with lupus in 5 patients.Active features of SLE were a frequent finding concomitant to Evans syndrome,including renal involvement in 13 cases (59.1%), arthritis in 9 patients (40.9%),rash in 6 patients (40.9%),neuropsychiatric manifestations in 4 cases(18.2%),etc.In addition,22.7% of our patients had an association with another autoimmune disease such as antiphospholipid syndrome.Conclusion Evans syndrome is a rare manifestation in SLE,

目的 探讨抗丙氨酰 tRNA 合成酶（alannyl tRNA synthetase，PL-12）抗体阳性的抗合成酶综合征（anti-synthetase syndrome，ASS）患者的临床特征。方法 分析2010年8月至2013年8月北京协和医院5例抗 PL-12抗体阳性 ASS 住院患者的临床表现、血清学结果和影像学改变。结果 5例抗 PL-12抗体阳性患者的基础疾病为皮肌炎2例，类风湿关节炎/干燥综合征、系统性硬化症和间质性肺炎各1例。5例患者均有肺间质病变，4例为首发和突出表现，胸部高分辨计算机断层扫描显示双下肺网格影和磨玻璃影为主；肺功能提示限制性通气功能和弥散功能障碍。典型皮肌炎皮损和技工手各2例，肌炎、关节炎、雷诺现象和发热各1例。胞浆型抗核抗体阳性4例，抗 Ro-52抗体阳性4例，抗 SSA 抗体阳性1例。5例患者中4例应用大剂量糖皮质激素（0．8～1．5 mg·kg ^-1·d^ -1）联合环磷酰胺（100 mg/d），1例还联用了甲氨蝶呤和环孢菌素 A，1例单独应用雷公藤多甙。治疗后3例患者病情好转，2例患者病情稳定。结论 抗 PL-12抗体与肺间质病变密切相关，而肌炎少见。

Objective The purpose of this study was to examine the clinical profile of patients with anti-alanyl-tRNA synthetase (anti-PL-1 2)antibody.Methods Five patients with anti-PL-1 2 antibody admitted into Peking Union Medical College Hospital were presented.The major clinical,serological,and radiographic data were analyzed.Results All 5 patients with anti-PL-1 2 antibody had evidence of interstitial lung disease (ILD)by clinical examination,imaging and pulmonary function tests.Clinical features presented were dry cough,gradual dyspnea,and crackles at lung bases.Lung function test showed a restrictive pulmonary dysfunction pattern and impaired gas exchange.High-resolution computed tomography scan revealed (predominantly basilar)reticular and ground-glass opacities,accompanied by a loss of lung volume,traction bronchiectasis,and scattered (usually peribronchovascular)areas of consolidation.This distinct pattern was highly suggestive of antisynthetase syndrome-related ILD.Four of 5 anti-PL-12

目的 总结血管炎性周围神经病的临床电生理及周围神经活检病理特点.方法 回顾性分析北京大学第三医院神经科15例血管炎性周围神经病患者临床表现、电生理特点及腓肠神经活检病理特点.结果 15例患者中,男8例,女7例,年龄38～82岁,周围神经病病程0.5～60个月.12例患者诊断为系统性血管炎性周围神经病,5例为原发性系统性血管炎,其中Churg-Strass综合征(CSS)2例,抗中性粒细胞胞浆抗体(ANCA)相关性血管炎3例;其余7例为继发性系统性血管炎,其中系统性红斑狼疮(SLE)1例,干燥综合征(SS)2例,类风湿关节炎(RA)3例,白塞病伴发甲状腺乳头状癌1例,乙型肝炎1例,1例患者SS伴发RA.3例患者诊断为非系统性血管炎性周围神经病.血管炎病理类型:1型4例,2型2例,3型9例.神经纤维病变类型:轴索变性为主8例,轴索变性伴脱髓鞘7例,其中2例伴局部神经束膜增厚.结论 血管炎性周围神经病的临床特点以多数性单神经病变和非对称性多神经病变多见;电生理特点以轴索病变为主,感觉、运动神经均受累,部分患者伴发脱髓鞘改变;神经病理特点为以轴索病变为主,可伴发脱髓鞘改变.

Objective To summarize the clinical features,electrophysiology and neuropathological characteristics of peripheral nerves in patients with vasculitic neuropathy.Methods We retrospectively analyzed the clinical,electrophysiology and neuropathological characteristics of 15 patients with vasculitic neuropathy who underwent electrophysiology and sural nerve biopsy in our department from January 2009 to June 2013.Results There were 8 males and 7 females,aged from 38 to 82 years old,with a peripheral neuropathy course ranged from 0.5 month to 60 months.In the total of 15 patients,3 patients were diagnosed as nonsystemic vasculitic neuropathy,while the other 12 patients were diagnosed as systemic vasculitis neuropathy (SVN) including 5 cases of primary systemic vasculitis and 7 cases of secondary systemic vasculitis.In patients diagnosed as primary systemic vasculitis,there were 2 cases of Churg-Strass syndrome (CSS) and 3 cases of ANCA associated vasculitis.In patients diagnosed as secondary