系统性红斑狼疮并发巩膜炎4例临床分析  

Clinical characteristics of 4 cases of scleritis associated with systemic lupus erythematosus

作　　者：王乐[1] 杨月[1] 贾园[1] 苗恒[2] 周云杉[1] 张晓盈[1] WANG Le YANG Yue JIA Yuan MIAO Heng ZHOU Yun-shan ZHANG Xiao-ying(Department of Rheumatology and Immunology Department of Ophtalmology,Peking University People＇ s Hospital, Beijing 100044, China)

机构地区：[1]北京大学人民医院风湿免疫科,北京100044 [2]北京大学人民医院眼科,北京100044

出　　处：《北京大学学报（医学版）》2016年第6期1081-1085,共5页Journal of Peking University:Health Sciences

基　　金：国家自然科学基金(31300721);高等学校博士学科点专项科研基金新教师类(20130001120066)资助~~

摘　　要：系统性红斑狼疮（systemic lupus erythematosus,SLE）是一种全身性自身免疫病,因多种自身抗体及血管炎的存在,患者可出现多器官、系统的受累。除脑、肺、心、肾等重要脏器外,还可出现眼部病变。眼部受累表现形式多样,从眼表到眼底疾病均可出现,其中以视网膜受累最为常见,也可出现巩膜受累。广义的巩膜炎包括表层巩膜炎及巩膜炎,其作为临床上一种相对少见的眼部疾病,发病率仅占眼部疾病总数的0．5％左右。Episcleritis and scleritis are relatively rare ocular diseases,which are commonly associated with rheumatic diseases including systemic lupus erythematosus（ SLE）. To investigate clinical and laboratory features of SLE-associated episcleritis and scleritis,we now report 4 cases of inpatients who were diagnosed with episcleritis or scleritis secondary to SLE from September 2005 to July 2016 in the Department of Rheumatology and Immunology in Peking University People＇s Hospital. Demographic,clinical and laboratory characteristics were summarized together with the treatment regimen and the prognosis; the literature was reviewed. There were 3 female and 1 male patients. The average age was（ 49. 0 ± 23. 8）years and the mean duration of SLE at the onset of episcleritis or scleritis was（ 2. 1 ± 1. 4） years. In addition to the eye involvement,the patients had mucocutaneous manifestations,serositis,lupus nephritis and interstitial pneumonia simultaneously; in the past,1 patient experienced arthritis,2 presented Raynaud＇s phenomenon,and 2 had hematologic involvement. All the patients had antinuclear antibody（ ANA） of high titer. The anti double-stranded DNA（ ds-DNA） antibody titers were increased in 2 patients. Three patients had positive anti-nucleosome antibody（ ANu A） while the other 1 patient did not test it. The complement levels were decreased in 3 patients. The systemic lupus erythematosus disease activity index（ SLEDAI） scores were more than 4 points in all the patients（ ranging from 7-16）,suggesting active disease. Ocular symptoms included pain,redness of the eye and tears. Ophthalmic examinations revealed 3 cases of episcleritis and 1 case of scleritis. Among the 4 patients,2 patients experienced ocular complications including decrease in vision and uveitis. All the patients were treated with systemic corticosteroids combined with hydroxycloroquine; 3 patients were treated with immunosuppressants（ cyclophosphamide in 2 patients and leflunomide in 1 patient）. All of the 4 p

关 键 词：红斑狼疮 系统性 巩膜炎 自身免疫疾病 

分 类 号：R593.24[医药卫生—内科学]