系统性红斑狼疮合并脊柱结核诊治分析  

Report of 2 case of systemic lupus erythematosus associated with tuberculous spondylitis and a clinical review

作　　者：王佳[1] 张伯科[1] 吴永贵[1] 齐向明[1] 张培[1] 

机构地区：[1]安徽医科大学第一附属医院肾内科,合肥230022

出　　处：《安徽医学》2010年第2期154-155,共2页Anhui Medical Journal

摘　　要：目的探讨系统性红斑狼疮(SLE)合并脊柱结核的诊断及内科治疗效果。方法对2例SLE合并脊柱结核患者临床资料进行回顾性分析。结果例1患者在正规抗结核4个月后局部神经压迫症状消失,疼痛明显改善。例2患者在抗结核治疗3个月后局部疼痛较入院时也明显减轻,同时MRI提示病灶明显减小。血沉及C反应蛋白均明显减低。2例患者在抗痨治疗过程中均无狼疮活动。结论正规抗结核联合激素及免疫抑制剂治疗SLE合并脊柱结核,不仅可以控制结核使其病灶减小,而且可以控制狼疮活动,同时避免了外科手术这一创伤。Objective To investigate the treatment of systemic lupus erythematosus（SLE） associated with tuberculous spondylitis by medical treatmentand and review the literature.Methods Two female patients with SLE associated with tuberculosis of the spine were retrospectively analyzed.Results After medical treatment for 4 months of the first patient,the numbness and weakness of both legs disappeared,and the back pain was obviously improved.For the second patient,after medical treatment for 3 months,the back pain was improved,and the MRI revealed the focus of infection was diminishing.Conclusion High dose of corticosteroids are implicated as a risk factor for infection in SLE patients.Early diagnosis and appropriate anti-tuberculosis treatment combined with prednisone and immunosuppression is beneficial in preventing the diffusion of SLE associated with tuberculous spondylitis and avoid surgical operation injury at the same time.

关 键 词：系统性红斑狼疮 脊柱结核 FK506 

分 类 号：R593.241[医药卫生—内科学]