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焦磷酸钙结晶沉积病的治疗

Authors
Michael A Becker, MD
Lawrence M Ryan, MD
Section Editor
Nicola Dalbeth, MBChB, MD, FRACP
Deputy Editor
Paul L Romain, MD

引言

双水焦磷酸钙(calcium pyrophosphate dihydrate, CPP)结晶沉积于结缔组织中可能并无症状，也可能引起多种临床综合征。这些疾病，包括急性和慢性炎性关节病以及影像学钙化，构成了焦磷酸钙结晶沉积病(calcium pyrophosphate crystal deposition, CPPD)的疾病谱[1-3]。

本文将讨论CPPD病的治疗。该病的发病机制、病因、临床表现和诊断将单独讨论。 (参见“Pathogenesis and etiology of calcium pyrophosphate crystal deposition (CPPD) disease”和“焦磷酸钙晶体沉积病的临床表现和诊断”)

术语

传统上用于描述CPP结晶沉积病(即，CPPD病)各种临床表现的名称包括：假痛风、软骨钙质沉着症和焦磷酸盐关节病。欧洲抗风湿病联盟(European league against rheumatism, EULAR)的共识小组提出了新的术语，并评审了这些疾病的诊断方法[4]。和旧术语有关的临床综合征、检查结果和局限性，以及EULAR提议的名称包括：

●假痛风–假痛风一词是指CPP诱发性滑膜炎的急性阵发性发作，其在临床上类似于尿酸盐痛风的急性发作。然而，多数CPPD患者从不出现此类发作，其只是CPPD病多种形式中的一种。因此，EULAR共识小组更倾向于使用“急性CPP结晶性关节炎”来描述急性发作，而不是假痛风。为免许多还不熟悉新命名的临床医生产生疑惑，我们在文中提到急性发作时会使用折中的“急性假痛风”一词。

●软骨钙质沉着症–软骨钙质沉着症是指透明软骨和/或纤维软骨中发生的影像学钙化。软骨钙质沉着症在CPPD病患者中很常见，但并不是CPP结晶的绝对特异性表现，也不是所有受累患者都会发生。EULAR小组将这种表现称为“软骨钙化(cartilage calcification, CC)”。

                

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Literature review current through: 2017-06 . | This topic last updated: 2017-02-07.
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