Clinical Comparison Of Adult-onset Still’s Disease And Systemic Juvenile Idiopathic Arthritis

Objective:This study aims to compare AOSD and sJIA of clinical manifestation,laboratory examination,treatment and prognosis,and explore the relationship and difference,providing early detection,diagnosis and treatment of diseases.It can also help with the sequential treatment of systemic juvenile idiopathic arthritis patients.Methods:Collecting and analyzing the clinical characteristic of 111 patients diagnosed AOSD and 43 patients with sJIA who were in the Fist Hospital of Jilin University from 1st Jan.2014 to 31st Dec.2017.The epidemiology,clinical manifestation,laboratory examination,therapy and prognosis of these two groups were compared.The count data was expressed as frequency and percentage,and theχ² test is used for comparison between groups.Conform to the normal distribution of measurement data is expressed in x±s.Compared with t test between groups,abnormal distribution of measurement data is expressed in M(P₂₅,P₇₅).Also comparison between groups use rank sum test.Two-tailed values<0.05 were considered to be statistically significant.Results:1.Comparing AOSD and sJIA,it was found that female is more likely to develop the disease of AOSD.While the gender ratio is similar with in s JIA.And the difference is statistically significant（P<0.05）.2.The patients with sJIA are more likely to be presented with sore throat,lymphadenopathy,arthralgia/arthritis,hepatomegaly,splenomegaly.While AOSD patients are more likely to appear rash,The above-mentioned differences were statistically significant.（P<0.05）.3.Neutrophilic granulocyte percentage,aspartate amino transferase,alanine aminotransferase,ferritin and lactic dehydrogenase have high level,ANA abnormal in AOSD are more than in patients with sJIA,while rising erythrocyte sedimentation rate and platelet are more in sJIA than AOSD patients,the differences were statistically significant（P<0.05）.The difference in hemoglobin,white blood cell count,C-reactive protein,rheumatoid factor positive rate between AOSD and sJIA were not statistically significant（P>0.05）.4.The treatment of the two groups is different,the AOSD patients are more likely to use glucocorticoid,and can be as based medicine joint DMARDs,patients with sJIA are more likely to use biological agents（tocilizumab）combined with glucocorticoid and DMARDs.5.AOSD patients have higher death rate（P=0.02）,and there is no significant difference between the two groups on remission,relapse（P>0.05）.6.Glucocorticoid+DMARDs combined with tocilizumab or IVIG was effective in some patients with refractory AOSD.sJIA patients were more likely combined tocilizumab,and the effect was better.Conclusions:1.There is a significant gender difference in AOSD patients,the prevalence of females is significantly higher than that of males,and the age of high incidence is17-40 years.There is no significant gender difference in sJIA patients,and the high-onset age is 7-14 years.2.The patients with sJIA are more likely to be presented with sore throat,lymphadenopathy,arthralgia/arthritis,hepatomegaly,splenomegaly.While,AOSD patients are more likely to appear rash.3.Laboratory examination in AOSD is more likely to present higher neutrophilic granulocyte percentage,transaminase,ferritin,lactic dehydrogenase.sJIA is more likely to appear erythrocyte sedimentation rate and platelet increase.4.AOSD patients have a higher risk of death than sJIA patients.Glucocorticoid+DMARDs combined with tocilizumab or IVIG was effective in some patients with refractory AOSD.sJIA patients were more likely combined tocilizumab,and the effect was better.