系统性红斑狼疮合并急性胰腺炎16例的临床特点和预后分析  

Clinical characteristics and prognostic analysis of 16 cases of systemic lupus erythematosus complicated with acute pancreatitis

作　　者：钟娃[1] 夏忠胜[1] 于钟[1] 于涛[1] 袁宇红[1] 陈其奎[1] 

机构地区：[1]中山大学孙逸仙纪念医院消化内科,广州510120

出　　处：《中华消化杂志》2015年第11期750-752,共3页Chinese Journal of Digestion

基　　金：广东省科技社会发展项目（20128031800030）

摘　　要：目的探讨系统性红斑狼疮（SLE）合并急性胰腺炎（AP）患者的临床特点和预后。方法收集1999年1月至2013年12月就诊的2526例SLE患者中合并AP的16例患者的病历资料。采用回顾性分析方法，分类整理并记录患者的临床特征，包括一般资料、既往史、临床表现、实验室检查结果、影像学检查结果、治疗、转归。非正态分布的计量资料行秩和检验，计数资料行Fisher确切概率法检验。结果SLE合并AP的发生率为0．63％（16／2526），其中轻症急性胰腺炎（MAP）10例，重症急性胰腺炎（SAP）6例。所有患者均予禁食、胃肠减压、营养支持、抑酸、抗炎、糖皮质激素、生长抑素等治疗。痊愈6例，好转7例；死亡3例，其中2例为SLE合并SAP患者，1例为SLE合并MAP患者。SLE合并SAP患者与SLE合并MAP患者相比，更多合并狼疮性肾病（6／6比5／10，Fisher确切概率法）、血液系统损伤（6／6比5／10，Fisher确切概率法）、肝损伤（5／6比0／10，Fisher确切概率法），受累器官较多（中位数为7个比3个，Z=-3．225），SLE疾病活动指数评分较高（中位数为13．5分比6．5分，Z=-2．876），差异均有统计学意义（P均〈0．05）。SLE合并AP死亡患者与SLE合并AP痊愈或好转患者相比，较多合并狼疮性脑病（2／3比1／13，Fisher确切概率法），受累器官较多（中位数为7个比5个，Z=-2．276），SLE疾病活动指数评分较高（中位数为21分比12分，Z=-2．195），差异均有统计学意义（P均〈0．05）。结论SLE合并SAP患者多见合并狼疮性肾病、血液系统损伤、肝损伤、SLE活动、多器官受累。SLE合并AP预后不佳患者多见SLE活动、多器官受累、合并狼疮性脑病。Objective To investigate the clinical characteristics and prognosis of patients with systemic lupus erythematosus （SLE） complicated with acute pancreatitis （AP）. Methods From January 1999 to December 2013, the clinical data of 16 patients with SLE complicated with AP among the total 2 526 cases of SLE was collected. A retrospective analysis was performed and the clinical data of patients was classified and documented, which included general information, past history, clinical symptoms, laboratory findings, imaging findings, treatment and outcome. The rank sum test was performed for analysis of non-normal distributed measurement data, and the Fisher＇s exact test was used for count data analysis. Results The incidence of SLE complicated with AP was 0.63% （16/2 526）. Among them, ten patients were mild acute pancreatitis （MAP） and six patients were severe acute pancreatitis （SAP）. All patients were treated with fasting, gastrointestinal decompression, nutritional support, anti-acid, anti- inflammatory, glucocorticoid and somatostatin and so on. Six patients were cured, seven patients improved and three patients died （two SIzE complicated with SAP, one SLE complicated with MAP）. Compared with the SLE patients complicated with SAP, the SLE patients complicated with MAP were more easily to have lupus nephritis（6/6 versus 5/10, Fisherrs exact test）, hematological system injuries （6/6 versus 5/10, Fisherrs exact test）, liver injuries （5/6 versus 0/10, Fisherrs exact test） ,more organs involved （mean 7 versus 3, Z=-3. 225） and higher SLE disease active indexes （DAD score （mean 13.5 versus 6.5, Z= -2. 876）; the differences were statistically significant （all P〈0.05）. Compared with the cured and improved SLE patients complicated with AP, lupus eneephalopathy （2/3 versus 1/13, Fisherrs exact test）, more organs involved （mean 7 versus 5, Z=-2. 276） and higher SLE DAI score （mean 21 versus 12, Z=-2. 195） was more common in dead SLE patients complicated with AP; t

关 键 词：红斑狼疮 系统性 急性胰腺炎 临床特点 预后 

分 类 号：R576[医药卫生—消化系统]