老年系统性红斑狼疮的临床分析  

Clinical Analysis of Systemic Lupus Erythematosus in the Elderly

作　　者：孟晶 李莉[1] 黎姣[1] Meng.ling;Li Li;Li Jiao(Department of Rheumatism and Nephrology,Wuhan Central Hospital AJfiliated to Tongji Medical College,Huazhong University of Science and Technology,Wuhan city,Hubei Province,430014,P.R.China)

机构地区：[1]华中科技大学同济医学院附属武汉中心医院风湿与肾内科,湖北武汉430014

出　　处：《老年医学与保健》2018年第3期274-277,共4页Geriatrics & Health Care

摘　　要：目的分析老年系统性红斑狼疮的临床特点。方法选取2017年2月—2018年2月来我院就诊的36例老年性红斑狼疮患者为观察组,同期就诊的40例中青年系统性红斑狼疮患者为对照组。观察并比较2组的临床表现、实验室相关检查指标变化、治疗方案和误诊情况等。结果与对照组相比,观察组浆膜炎、肾、肺、心脏、血液系统、肌肉痛和神经损害发生率均显著高于对照组(<0.05);观察组蝶形红斑、肾损害发生率显著低于对照组(<0.05);观察组抗ds-DNA抗体阳性、C-反应蛋白(CPR)升高、红细胞沉降率(ESR)升高、尿蛋白阳性发生率均显著低于对照组(<0.05);观察组接受间歇静脉滴注环磷酰胺疗方案的比例显著低于对照组(<0.05);观察组患者的首次就诊误诊率显著高于对照组(36.11%15.00%,<0.05)。结论老年统性红斑狼疮患者起病隐匿,且疾病活动指数低,容易漏诊和误诊,应该引起重视。Objective To analyze the clinical characteristics of systemic lupus erythematosus（SLE） in the elderly.Methods 36 elderly with SLE during the period from Feb., 2017 to Feb., 2018 were selected as observation group while 40 young and middle-aged cases with SLE during the same period were selected as control group; a comparative study was made to The clinical manifestations, changes in laboratory test indicators, clinical treatment options and misdiagnosis between the 2 groups. Results The incidence of serositis, the damage to kidney, lung, heart and blood system, the muscle pain and nerve damage in observation group was significantly higher than that in control group, and the difference was statistically significant（ 0.05）; the incidence of butterfly erythema in observation group was significantly lower than that in control group, and the difference was statistically significant（P 0.05）; the rates of positive anti-ds-DNA antibody, elevated C-reactive protein（CPR）,increased erythrocyte sedimentation（ESR） and positive urine protein in observation group were significantly lower than those in control group with statistically significant differences（ P0.05）; much less intermittent intravenous cyclophosphamide therapy were performed in observation group than in control group, the difference was statistically significant（ P0.05）; the initial misdiagnosis rate in observation group was 36.11%, significantly higher than that in control group（15.00%）（ P0.05）. Conclusions Missed diagnosis and misdiagnosis of SLE occur often due to the latent onset and low activity of disease index, more attention should be paid.

关 键 词：老年 系统性红斑狼疮 临床表现 误诊 

分 类 号：R593.241[医药卫生—内科学]