老年系统性红斑狼疮48例临床分析  

Clinical analvsis of 48 cases of older-onset systemic lupus erythematosus

作　　者：李真真[1] 李冬芹[1] 张金凤 罗杨[1] 

机构地区：[1]郑州大学第一附属医院皮肤科,450052 [2]焦作人民医院皮肤科

出　　处：《中华皮肤科杂志》2013年第8期586-588,共3页Chinese Journal of Dermatology

摘　　要：目的探讨老年发病的系统性红斑狼疮（SLE）患者的临床特点。方法回顾性分析郑州大学第一附属医院2008年1月至2011年1月住院的48例临床资料完整的老年SLE患者的临床资料和实验室检查结果，并与同期住院的424例非老年组SLE患者进行比较。结果472例SLE患者男女比例为1：8．08，老年患者占同期所有SLE患者的10．17％。与非老年组SLE患者相比，老年组患者男女比例（1：3．8）较高；关节炎、发热、血红蛋白减低、红细胞沉降率升高、补体c4降低的发生率；抗RNP抗体及抗sm抗体阳性的发生率降低，两组差异均无统计学意义（P〉0．05）。SLE老年组患者肌痛、肌无力、浆膜炎、心脏损害、肺脏损害、白细胞降低和血小板降低的发生率均高于非老年组患者，而蝶形红斑、脱发、肾脏损害、雷诺现象、光敏感、补体C3降低的发生率和抗双链DNA抗体以及抗核小体抗体（AnuA）的阳性率均低于非老年组，差异均有统计学意义（P〈0．05）。结论老年SLE患者临床特征具有轻型化、非典型化特点，特异性较高的免疫指标阳性率较低，临床上应避免漏诊误诊。Objective To assess the clinical feature of older-onset systemic lupus erythematosus. Methods A retrospective study was carried out. Clinical and laboratory findings were collected from 48 patients with older-onset （〉 or = 50 years） SLE as well as 424 patients with younger-onset （〈 50 years） SLE hospitalized in the First Affiliated Hospital of Zhengzhou University from January 2008 to January 2011. Results Among the 472 hospitalized patients with SLE, the ratio of male to female was 1：8.08, and older-onset SLE accounted for 10.17%. No significant difference was observed in the incidence of fever, arthritis, decrease in hemoglobin level, increase in erythrocyte sedimentation rate and reduction in complement C4 level, or the positivity rate of anti-ribonucleoprotein （RNP） or anti-Sm autoantibodies （all P 〉 0.05） between the older-onset and younger-onset SLE patients. The patients with older-onset SLE showed a statistically higher incidence of myalgia, myasthenia, serositis, heart damage and lung damage, decrease in white blood cell count and platelet count, but a significantly lower incidence of butterfly rash, alopeeia, renal damage, Raynaud＇s phenomenon, photosensitivity, decrease in complement C3 level, as well as the positivity rate of anti-dsDNA and anti-nucleosome antibodies in comparison with those with younger- onset SLE （all P 〈 0.05）. Conclusions It is likely that older-onset SLE has mild and atypical clinical manifestations, with a relatively low positivity rate of specific immunological indices. Hence, clinicians should pay more attention to older-onset SLE so as to avoid the misdiagnosis or missed diagnosis of it.

关 键 词：系统性红斑狼疮 老年发病 临床分析 SLE患者 抗双链DNA抗体 实验室检查结果 抗SM抗体阳性 非老年组 

分 类 号：R593.241[医药卫生—内科学]