老年性系统性红斑狼疮的临床特点及预后  

The Clinical Features and Outcomes of Systemic Lupus Erythematosus in Ageing Patients

作　　者：崔惠敏[1] 张秋生[1] 菅宏蕴[1] 吴素红[1] 陈小红[1] 刘冠贤[2] 

机构地区：[1]广东省中山市人民医院肾内科,中山528403 [2]广东省惠州市中心人民医院肾内科,惠州516000

出　　处：《中国中西医结合肾病杂志》2005年第7期386-388,共3页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：广东省医学科研基金资助项目(No.A2003819)

摘　　要：目的探讨老年性系统性红斑狼疮(SLE)的临床特点及预后。方法58例老年性SLE的主要临床表现、实验室检查、诊断、疗效及预后与非老年组76例对比分析。结果与非老年组比较,老年组浆膜炎、肺部病变、肌病、体重减轻、贫血、白细胞和血小板计数减少的发生率较高(P<0.05),发热、面颊皮疹、光过敏、口腔溃疡、脱发、雷诺现象、肾损害、神经精神症状、补体C3低下、抗ds-DNA(+)、抗SM(+)的发生率较低(P<0.05),初诊误诊率和男性发病率较高(P<0.05),治疗有效率较高,死因并非全是SLE。结论老年性SLE临床表现不典型、重症型较少、易误诊,应避免过度治疗。Objective:To investigate the clinical features and outcomes of systemic lupus erythematosus(SLE) in ageing patients.Methods:The main clinical characteristics, laboratory data, diagnosis course, treatment effects, follow-up outcomes of 58 ageing patients with SLE were analyzed by compared with 76 non-ageing cases.Results:Compared with non-ageing group,the incidences of serositis, pulmonary involvement,muscle pain,loss of body,anemia,leukopenia,thrombocytopenia in ageing group were higher;the incidences of fever, malar rash, photosensitivity, mouth ulcerations,alopecia(hair loss),Raynaud phenomenon, nephropathy, neuropsychiatric manifestations,low complement C_3,positive anti-ds-DNA, positive anti-SM in ageing group were lower;the rates of initial stage misdiagnosis and male patients in ageing group were higher.The effective rate of treatment was higher and the causes of death were usually not directly relating to SLE in ageing group.Conclusion:For SLE in ageing patients, the clinical manifestations of are atypical and the cases of severe pattern are fewer and it is easy to be misdiagnosed. Excessive treatment should be avoided in ageing patients with SLE.

关 键 词：系统性红斑狼疮 临床特点 老年性 预后 临床表现不典型 主要临床表现 神经精神症状 非老年组 实验室检查 血小板计数 治疗有效率 SLE 对比分析 肺部病变 体重减轻 口腔溃疡 雷诺现象 过度治疗 发生率 浆膜炎 白细胞 光过敏 

分 类 号：R593.241[医药卫生—内科学] R776.1[医药卫生—临床医学]