晚发性系统性红斑狼疮患者临床分析  

Clinical analysis of late-onset systemic lupus erythematosus in Xinjiang

作　　者：石亚妹[1] 罗采南[1] 米克拉依[1] 武丽君[1] 

机构地区：[1]新疆维吾尔自治区人民医院风湿免疫科,乌鲁木齐830000

出　　处：《中华老年医学杂志》2017年第9期987-991,共5页Chinese Journal of Geriatrics

摘　　要：目的探讨新疆地区晚发性发病的系统性红斑狼疮（SLE）的临床特点。方法系统性回顾分析2006年1月至2016年7月在新疆维吾尔自治区人民医院风湿免疫科住院的87例晚发性SLE的临床资料及实验室检查，并与其中的222例非晚发性SLE进行比较。结果（1）87例晚发性SLE组中女男比例为5．7；1．0，222例非晚发性SLE组中女男比例为11．3：1．0；（2）晚发性SLE组中有13例（14．9％）有诱发因素，11例为感染（12．6％）；非晚发性SLE组有27例（12．2％）有诱发因素，除感染外还有妊娠、流产、日晒等因素；（3）晚发性SLE组中常见的临床表现有：关节炎55例（63．2％），乏力35例（40．2％），皮疹32例（36．8％），食欲减退23例（26．4％），气短23例（26．4％）；晚发性SLE组较非晚发性SLE组食欲减退发生率高（χ^2=10．157，P=0．001），而脱发发生率低（χ^2=16．96，P=0．000），差异均有统计学意义。（4）晚发性SLE组转氨酶升高（χ^2=4．619，P=0．032）、肌酐升高（χ^2=8．365，P=0．004）、血小板下降（χ^2=6．183，P=0．013）较非晚发性SLE组高，差异均有统计学意义，而抗Sm抗体阳性率（χ^2=8．012，P=0．005）、抗Acl抗体阳性率（χ^2=5．459，P=0．019）低于非晚发性SLE组，差异均有统计学意义。（5）汉族晚发性SLE组较维吾尔族、哈萨克族等少数民族晚发性SLE组口腔溃疡发生率高（31．7％／7．4％），差异有统计学意义（χ^2=5．984，P=0．014），而在实验室指标之间无明显差异。结论新疆地区老年发病的SLE男性比例较非晚发性SLE组高，汉族晚发性SLE较少数民族晚发性SLE更易出现口腔溃疡，但早期临床症状不典型，特异性抗体阳性率低，在临床工作中应提高警惕，避免误诊及漏诊。Objective To assess the clinical characteristics of systemic lupus erythematosus （SLE） in the elderly in Xinjiang. Methods As a retrospective study, clinical date and laboratory test results were collected from 87 elderly SLE patients and 222 non-elderly SLE patients （age〈50 years） hospitalized in the People＇s Hospital of the Xinjiang Uygur Autonomous Region from January 2006 to July 2016. Results The female to maleratio was 5.7 ： 1.0 in the older-onset SLE group and the female to male ratio was 11.3 ： 1.0 in the younger-onset SLE group. Of the 13 patients with predisposing factors in the older-onset SLE group（14.9 % ）, 11 had infection （ 12.6 % ）, whereas the 27 patients with predisposing factors in the younger-onset SLE group （12.2 % ）had pregnancy, abortion or insolation, in addition to infection. Arthritis （ 63.2 % ）, weakness （ 40.2 % ）, malar rashes （ 36.8 % ）, anorexia（26.4 % ）, and shortness of breath（26.4 % ） were common clinical manifestations in the olderonset SLE group. The incidence of anorexia in the older-onset SLE group was higher than that in the younger-onset SLE group（P〈0.01）, while the incidence of trichomadesis was lower in the older-onset SLE group than that in the younger-onset SLE group（P〈0.01 ） ; Aminotransferase elevation, creatinine elevation and thrombocytopenia were more common in the older-onset SLE group than in the younger SLE group （P〈0.05）. Lower rates of positive anti-Smanti body and anti-Acl antibody were found in the older-onset SLE group, compared with the younger-onset SLE group （P〈 0.05） ; Han older-onset SLE patients showed higher rates of oral ulcers than older-onset SLE patients of Uygur, Kazak or other ethnic minorities （P〈0.05）. There were no significant differences between Han and Uygur/Kazak patients in laboratory test results. Conclusions The proportion of male SLE patients in the elderly is higher than that in non-elderly SLE patients in Xinjiang. Also, elderly SLE patients are prone to o

关 键 词：红斑狼疮 系统性 

分 类 号：R593.241[医药卫生—内科学]