结缔组织病合并乳糜性胸腹腔积液5例并文献复习  

Connective Tissue Disease Complicated with Chylothorax and Chylous Ascites:Reports of Five Cases with Literature Review

作　　者：张国华[1] 王玉华[1] 夏蓉晖[1] 赵绵松[1] 

机构地区：[1]首都医科大学附属北京世纪坛医院风湿免疫科,北京100038

出　　处：《中华临床免疫和变态反应杂志》2013年第4期335-339,共5页Chinese Journal of Allergy & Clinical Immunology

基　　金：北京市自然科学基金(7123220);北京世纪坛医院青年基金(2012-QB01)(2012-QB05)

摘　　要：目的总结分析5例结缔组织病合并乳糜胸腹腔积液患者的临床特点。方法收集并分析首都医科大学附属北京世纪坛医院2002年1月至2013年1月确诊的5例结缔组织病合并乳糜胸腹腔积液患者的临床表现、辅助检查及治疗转归等资料。结果5例患者均为女性，年龄31—68岁，平均45．8岁；结缔组织病合并乳糜性胸腹腔积液的病程为1～12个月，平均5．6个月。5例患者中系统性红斑狼疮患者3例，系统性硬化症患者1例，未分化结缔组织病患者1例。5例淋巴系统受累患者中，4例为乳糜性胸腹腔积液，1例为乳糜性胸腔积液。5例患者中4例给予糖皮质激素治疗，2例联合免疫抑制剂治疗，2例患者临床症状明显缓解。结论结缔组织病合并乳糜胸腹腔积液罕见，应引起风湿科医生的重视，早期干预，积极治疗，改善患者的生活质量及预后。To investigate the clinical features of 5 cases with connective tissue disease complicated with chylothorax and chylous ascites. Methods Clinical manifestations, laboratory examination, treatment and prognosis of 5 patients with connective tissue disease complicated with chylothorax and chylous ascites, who were admitted to our center in recent 11 years, were retrospectively analyzed. Results Five patients were female. The average age at presentation was 45.8 years （ranging from 31 to 68 years）. The average disease duration of chylothorax and chylous aseites was 5.6 months （ ranging from 1 to 12 months）. Of the 5 patients, 3 were diagnosed with systemic lupus erythematosus, 1 with systematic selerosis and 1 with undifferentiated eonneetive tissue disease respectively. Of the 5 patients, 4 patients were complicated with chylothorax and ehylous ascites, and 1 patient with ehylothorax. Four patients were treated with cortieosteroid, of which, 2 patients were treated with combined steroid and immunosuppressive agents. Chylothorax and chylous ascites improved in 2 patients. Conclusion The clinical manifestations of chylothorax and chylous aseites were relatively rare in patients with eonneetive tissue disease. We should pay attention to this rare eomplication so as to improve the prognosis.

关 键 词：结缔组织病 乳糜 胸腹腔积液 

分 类 号：R593.2[医药卫生—内科学] R561.7[医药卫生—临床医学]