消化系统受累的系统性红斑狼疮临床分析(1)
[摘要] 目的 探讨系统性红斑狼疮(SLE)消化道受累的临床特征和实验室检查结果，为早期诊断、早期治疗及改善预后提供临床依据。 方法 回顾性分析2006年12月～2013年12月本院收治的30例消化系统受累的SLE患者的临床资料和实验室检查结果，选择同期60例无消化系统受累的SLE患者作为对照组，比较实验结果。 结果 SLE消化系统受累的患者，消化系统各个部位皆可受累，SLE消化系统受累更容易合并泌尿系统受累，血清白蛋白、C3水平、CH50水平、ANCA阳性率、D二聚体水平等与对照组比较，差异有统计学意义(P<0.05)。 结论 SLE消化系统受累较为常见，部分为SLE患者的首发表现。SLE消化系统受累多属狼疮重症，预后不良，需要较大剂量的激素及免疫抑制剂治疗，抗凝治疗较为重要，临床应予以重视，早期诊断、早期治疗，改善预后。在临床实践中有指导意义。
[关键词] 系统性红斑狼疮；消化系统；诊断
[中图分类号] R593.24+1 [文献标识码] A [文章编号] 1674-4721(2015)05(b)-0043-03
Clinical analysis of systemic lupus erythematosus with digestive system involvement
ZHENG Ke-di
Department of Rheumatology，Center Hospital of Shantou City in Guangdong Province，Shantou 515041
[Abstract] Objective To study the clinical features and laboratory examination results of systemic lupus erythematosus(SLE) with digestive system involvement，and provide clinical evidence for early diagnosis，early treatment and the prognosis. Methods 30 patients with digestive system involvement SLE in our hospital from December 2006 to December 2013 were selected and clinical data and laboratory test results was analysied retrospectively.60 patients without gastrointestinal involvement in SLE patients as control group at the same time，the experimental results was compared between two groups. Results SLE digestive system involvement in patients with digestive system，each part was affected，SLE gastrointestinal involvement was more easily combined with urinary system involvement，serum albumin level，C3，CH50 level，positive rate of ANCA，D-dimer level was compared respectively with control group，with statistical difference(P<0.05). Conclusion SLE with digestive system is common，and part is the first manifestation of SLE patients.Digestive system involvement in SLE is severe lupus，poor prognosis and need larger doses of hormones and immunosuppressive therapy，anticoagulant therapy is more important，clinical should pay more attention to it，early diagnosis，early treatment and improve the prognosis.Have the guiding significance in clinical practice.
[Key words] Systemic lupus erythematosus(SLE)；Digestive System；Diagnosis
系统性红斑狼疮(systemic lupus erythematosus，SLE)是自身免疫异常引起的多脏器多系统功能损害性疾病[1]。本病病因尚未明确，在遗传素质、环境因素、雌激素水平等各种因素相互作用下，T淋巴细胞减少、功能降低，B细胞过度增生，产生大量抗体，与体内相应抗原结合形成免疫复合物，沉积在皮肤、关节、小血管、肾小球等部位，引起急、慢性炎症及组织坏死，或抗体直接与抗原作用，引起细胞破坏，导致机体多系统受损。除常见的皮疹、关节痛、口腔溃疡等表现外，常伴有肺部、心脏、肾脏、神经系统、血液系统受累的症状，SLE患者中，消化系统受累比较常见，不少SLE患者发病以消化系统受累为首发症状，临床特异性不高，易造成误诊，SLE消化系统受累者病情较重，若早期未能给予及时有效治疗，预后不佳。为降低误诊率，早期治疗，提高SLE的诊治水平，本研究对30例消化系统受累的SLE患者的临床表现及检查结果进行回顾性分析，以60例无消化系统受累的SLE患者作为对照组，比较实验结果。 (郑可弟)
[关键词] 系统性红斑狼疮；消化系统；诊断
[中图分类号] R593.24+1 [文献标识码] A [文章编号] 1674-4721(2015)05(b)-0043-03
Clinical analysis of systemic lupus erythematosus with digestive system involvement
ZHENG Ke-di
Department of Rheumatology，Center Hospital of Shantou City in Guangdong Province，Shantou 515041
[Abstract] Objective To study the clinical features and laboratory examination results of systemic lupus erythematosus(SLE) with digestive system involvement，and provide clinical evidence for early diagnosis，early treatment and the prognosis. Methods 30 patients with digestive system involvement SLE in our hospital from December 2006 to December 2013 were selected and clinical data and laboratory test results was analysied retrospectively.60 patients without gastrointestinal involvement in SLE patients as control group at the same time，the experimental results was compared between two groups. Results SLE digestive system involvement in patients with digestive system，each part was affected，SLE gastrointestinal involvement was more easily combined with urinary system involvement，serum albumin level，C3，CH50 level，positive rate of ANCA，D-dimer level was compared respectively with control group，with statistical difference(P<0.05). Conclusion SLE with digestive system is common，and part is the first manifestation of SLE patients.Digestive system involvement in SLE is severe lupus，poor prognosis and need larger doses of hormones and immunosuppressive therapy，anticoagulant therapy is more important，clinical should pay more attention to it，early diagnosis，early treatment and improve the prognosis.Have the guiding significance in clinical practice.
[Key words] Systemic lupus erythematosus(SLE)；Digestive System；Diagnosis
系统性红斑狼疮(systemic lupus erythematosus，SLE)是自身免疫异常引起的多脏器多系统功能损害性疾病[1]。本病病因尚未明确，在遗传素质、环境因素、雌激素水平等各种因素相互作用下，T淋巴细胞减少、功能降低，B细胞过度增生，产生大量抗体，与体内相应抗原结合形成免疫复合物，沉积在皮肤、关节、小血管、肾小球等部位，引起急、慢性炎症及组织坏死，或抗体直接与抗原作用，引起细胞破坏，导致机体多系统受损。除常见的皮疹、关节痛、口腔溃疡等表现外，常伴有肺部、心脏、肾脏、神经系统、血液系统受累的症状，SLE患者中，消化系统受累比较常见，不少SLE患者发病以消化系统受累为首发症状，临床特异性不高，易造成误诊，SLE消化系统受累者病情较重，若早期未能给予及时有效治疗，预后不佳。为降低误诊率，早期治疗，提高SLE的诊治水平，本研究对30例消化系统受累的SLE患者的临床表现及检查结果进行回顾性分析，以60例无消化系统受累的SLE患者作为对照组，比较实验结果。 (郑可弟)