系统性红斑狼疮血液系统损害及相关抗体检测的临床意义  

The clinical significance of hematological damage in systemic lupus erythematosus and related antibodies

作　　者：赵小英[1] 张萍[2] 黄连生[1] 张晓红[1] 

机构地区：[1]浙江大学医学院附属第二医院血液科,杭州310009 [2]浙江大学医学院附属儿童医院血液科

出　　处：《中华内科杂志》2006年第5期369-371,共3页Chinese Journal of Internal Medicine

摘　　要：目的探讨系统性红斑狼疮(SLE)血液系统受损发生率与SLE病情活动程度及相关免疫指标的关系。方法回顾性分析155例SLE患者的临床资料及相关的实验室指标,应用χ2检验进行统计学分析。结果155例SLE患者血液系统受损占67.7%,单系血细胞减少占32.9%,两系及两系以上受损占34.8%。血液系统损害组中AntiSm和AntiRNP检出的阳性率分别为43.8%和64.8%,高于无血液系统损害组的26.0%和44.0%。单系红细胞减少组中AntiRNP阳性率为69.0%高于无血液系统损害组的44.0%,而单系白细胞或血小板减少组与无血液系统损害组AntiRNP阳性率差异无统计学意义。SLE活动组49例,非活动组106例,SLE活动组中血液系统损害的发生率为75.5%,非活动组为64.2%,活动组AntidsDNA、AntiRNP、AntiSm抗体的阳性率高于非活动组,且多系血细胞受损比单系损害发生率高。结论血液系统是SLE易并发损害的器官,并与其病情活动有关。AntiRNP可反映血液系统红系损害。Objective To investigate the incidence of hematological damage in systemic lupus erythematosus （SLE） and its relationship with disease state and immunological parameters of SLE. Methods 155 inpatients with SLE were enrolled in this retrospective study in our hospital. All patients fulfiled the criteria of SLE drawn up by American Rheumatism Association （ARA） in 1982. Fasting blood samples were obtained and blood routine,liver and renal function, immunological parameters were determined. Acording to SLE Disease Activity Index （SLEDAI）, disease state was evaluated in 155 patients and their correlation parameters were analyzed, with hematological damage and immunological parameters analyzed. Results 67.7% of the patients had hematological disorder. Single cell line damage was present in 32. 9% of the patients, while 34. 8% of the patients were involved in damage of several cell lines. The detectable rate of Anti-Sin （43. 8% ） and Anti-RNP（64. 8% ） in patients with hematological disorder were higher than those in patients without hematological disorder （ Anti-Sin 26. 0%, Anti-RNP 44. 0% ）. The positive rate of Anti- RNP were 69. 0% in patients with red cell line damage while only 44. 0% in patients without hematological disorder（ P 〈 0. 05 ）. There was no significant difference in Anti-RNP between patients without hematological disorder and patients with leucocytopenia or thrombocytopenia. Among the 155 patients 49 were in progressive stage and 106 in stationary stage. Hematological damage occurred approximately in 75.5% of the patients in progressive stage and in 64. 2% of the patients in stationary stage. The prevalences of Anti-dsDNA, Anti- RNP, Anti-Sin and several cell lines damage were significantly higher in patients with progressive stage than in patients with stationary stage. Conclusions Hematological system is easily damaged in patients with SLE and its involvement is related with the disease state. Anti-RNP could reflect red cell line damage.

关 键 词：贫血 抗体 系统性红斑狼疮 血液系统损害 

分 类 号：R593.241[医药卫生—内科学] R552[医药卫生—临床医学]