未分化结缔组织病合并蛋白丢失性肠病4例临床分析  

Undifferentiated connective tissue disease complicated with protein-losing enteropathy in 4 cases

作　　者：王培[1] 朱清[1] 闫磊[1] 邵凤民[1] 

机构地区：[1]郑州大学人民医院河南省人民医院肾病风湿免疫科,郑州450003

出　　处：《中华实用诊断与治疗杂志》2015年第12期1202-1203,共2页Journal of Chinese Practical Diagnosis and Therapy

基　　金：十二五国家科技支撑计划(2011BAI10B04);河南省重大科技攻关项目(121100910600)

摘　　要：目的分析总结未分化结缔组织病(undifferentiated connective tissue disease,UCTD)合并蛋白丢失性肠病(protein-losing enteropathy,PLE)临床、实验室特点、治疗方案及转归。方法回顾性分析4例UCTD并发PLE患者的临床资料。结果临床主要表现为水肿、腹胀、雷诺现象;实验室检查示低蛋白血症4例,尿蛋白阳性1例,血脂增高4例,球蛋白下降2例,糖类抗原125升高2例,抗RNP阳性2例,抗SSA/Ro阳性2例;电子内镜有全结肠炎症改变,结肠多发息肉2例;^(99m)锝标记的白蛋白闪烁显像小肠蛋白丢失4例;均给予激素及免疫抑制剂治疗,同时给予白蛋白、利尿、抗凝等治疗,随访至2015年5月,4例患者病情平稳。结论 UCTD合并PLE临床少见,当患者出现不明原因低蛋白血症时,应考虑PLE的可能并注意筛查UCTD,经激素及免疫抑制剂治疗后,多数患者预后良好。Objective To investigate the clinical manifestations, laboratory examination results, treatment and prognosis of undifferentiated connective tissue disease （UCTD） complicated by protein-losing enteropathy （PLE）. Methods The clinical data of 4 UCTD patients complicated with PLE were retrospectively analyzed. Results All UCTD patients complicated with PLE were clinically manifestated by edema, abdominal distention and Raynaud phenomenon. Laboratory results revealed hypoalbuminemia in all 4 patients, positive urine protein in 1, increased lipid level in 4, decreased globulin in 2, elevated carbohydrate antigen 125 in 2, positive anti-RNP in 2 and positive anti-SSA in 2. Electronic colonoscope revealed colitis and colonic polyps in 2 patients. Leakages of protein form gastrointestinal tract was investigated by use of ^99mTc-labeled albumin scintigraphy in 4 patients. All patients received glucocorticoids and immunosuppressants, followed by intravenous injection of albumin, anticoagulant therapy and diuresis. By the end of May, 2015, all patients were in good conditions. Conclusion UCTD complicated with PLE is rarely found. PLE should be considered and UCTD should be screened when the patients have unexplained hypoalbuminemia. The prognosis is fine after the treatment with corticosteroids and immunosuppressants.

关 键 词：结缔组织病 蛋白丢失性肠病 糖皮质激素 免疫抑制剂 

分 类 号：R593.2[医药卫生—内科学]