系统性红斑狼疮皮肤血管炎的临床特点分析  

Clinical characteristics of cutaneous vasculitis secondary to systemic lupus erythematosus.

作　　者：李博[1,2] 胡秋侠 钟桂芳 何伟珍[1,2] 孔卫红[1,2] 李剑松[1,2] 张丽君[1,2] 叶志中[1,2] 

机构地区：[1]深圳市第四人民医院香蜜湖风湿病分院风湿科 [2]广东医学院深圳风湿病研究所,广东深圳518040 [3]深圳市福田区中医院门诊,广东深圳518034 [4]深圳市第四人民医院肛肠分院,广东深圳518509

出　　处：《海南医学》2012年第14期11-13,共3页Hainan Medical Journal

基　　金：深圳市医学重点学科建设经费资助项目(编号:2005C10);深圳市科技计划项目(医疗卫生类)(编号:201002145)

摘　　要：目的探讨继发于系统性红斑狼疮(SLE)的皮肤血管炎(CV)的发生率及临床特点。方法对先后在本院门诊就诊及住院的SLE进行临床资料收集与分析。皮肤血管炎的诊断主要基于临床表现,即出现提示皮肤血管炎的典型临床表现,例如肢端红斑、网状青斑、可触及性紫癜、皮肤溃疡等,并排除血栓性疾病及药物反应等其他可能的原因。同时需一位资深皮肤科医生会诊证实CV的诊断。结果在278例入选的SLE患者中,有103例患者有典型的CV表现,CV的发生率为37%,其中84例(82%)为女性患者,19例(18%)为男性患者。CV最常见的临床表现为肢端红斑。最常被累及的部位为指端及手掌。其他常被累及部位依次为下肢、上肢、躯干及面部。CV的持续时间从不满1周至数月不等,平均3.7周。与没有CV的SLE患者相比,具有CV的SLE患者女性/男性比例较低,SLEDAI评分较高,雷诺现象、血液系统累及、高丙球蛋白血症发生率较高(P<0.05)。结论 SLE中CV的发生率为37%,在临床十分常见,而且CV的临床表现较为复杂。伴发CV表现的SLE患者的女性/男性比例较低,临床表现更重,并更容易出现雷诺现象、血液系统累及、高丙球蛋白血症。Objective To investigate the prevalence and clinical characteristics of cutaneous vasculitis （CV） secondary to systemic lupus erythematosus （SLE）. Methods The clinical data of 278 consecutive patients with SLE were collected and analyzed. The diagnosis of CV was based on the clinical symptoms, including acral erythema, livedo reticularis, purpura, and skin ulcers. Thrombotic diseases and drug reactions should be excluded. The disease should be confirmed by an experienced dermatologist. Results CV secondary to SLE was found in 103 （37%） of the 278 patients, including 84 （82%） females and 19 （18%） males. The most common presentation of CV was acral erythema. The site affected most commonly was fingertips and palms. Other sites often affected were the lower limbs, upper limbs, trunk and face, in order of frequency. The duration of the skin lesions ranged from less than a week to several months, with an average of 3.7 weeks. Patients with CV presented a lower female/male ratio and a higher mean SLEDAI score, and had a higher incidence of raynaud phenomenon, blood system involvement, hypergammaglobulinemia （P〈0.05）. Conclusion The presentation of CV secondary to SLE was complicated. The patients with CV was associated with a lower female/male ratio, a higher mean SLEDAI score, a higher incidence of raynaud phenomenon, blood system involvement, hypergammaglobulinemia.

关 键 词：皮肤血管炎 红斑狼疮 系统性 继发性 

分 类 号：R593.241[医药卫生—内科学]