系统性红斑狼疮合并非原发性胆汁性肝硬化患者的临床特征  

The clinical characteristics of 11 cases of systemic lupus erythematosus with non primary biliary cirrhosis

作　　者：王娟娟 施宏莹[1] 郑世滩 WANG Juan-juan;SHI Hong-ying;ZHENG Shi-tan(Department of Rheumatology and Emergency Internal Medicine,the Second Affiliated Hospital of Fujian Medical University,Quanzhou,362000,China)

机构地区：[1]福建医科大学附属第二医院风湿免疫科,泉州362000 [2]福建医科大学附属第二医院急诊内科,泉州362000

出　　处：《肝脏》2020年第5期491-493,共3页Chinese Hepatology

基　　金：通信作者:王娟娟,Email:[e-mail]。

摘　　要：目的 了解系统性红斑狼疮(SLE)合并非原发性胆汁性肝硬化患者的临床特点。方法 回顾性分析2013年1月至2019年1月在福建医科大学附属第二医院住院治疗的11例SLE合并非原发性胆汁性肝硬化患者的一般情况、临床表现、实验室检查、治疗及预后转归。结果 11例患者均为女性,中位年龄57岁,病情均为危重;7例患者以肝硬化首发后诊断SLE,其中3例出院1 d死亡,1例1年后死亡;2例住院期间出现肝性脑病、肾功能不全及胆红素、CA199、CA125明显升高,病情进展迅速,放弃治疗出院1 d后死亡;3例患者目前病情相对稳定,其中1例为既往有SLE基础的患者规律治疗SLE,1例为合并HBV感染的患者规律行抗病毒治疗。结论 SLE合并非原发性胆汁性肝硬化以女性多见,病情危重,预后差;以肝硬化首发SLE患者预后更差;出现肝性脑病、肾功能不全或胆红素、CA199、CA125明显升高可能是预后不良的因素;对既往有SLE基础的患者规律治疗SLE,对合并HBV感染的患者规律抗病毒治疗可能改善预后。Objective To investigate the clinical characteristics of systemic lupus erythematosus with non primary biliary cirrhosis.Methods Retrospectively assessed 11 cases diagnosed as systemic lupus erythematosus with non primary biliary cirrhosis between January 2013 and January 2019 at the Second Affiliated Hospital of Fujian Medical University.Results They were all female with median age of 57-year-old and their condition were all severe;7 cases were first diagnosed as SLE because of discovery of cirrhosis,with 3 of them passing away 1 day after living hospital and 1 passing away after 1 year.2 patients with hepatic encephalopathy,renal insufficiency,high bilirubin,largely elevated CA125 and CA199 had a rapid deterioration of illness and died in a short time.Only 3 cases of them were stable,1 case with a history of SLE before having regular treatment of SLE and 1 case diagnosed as hepatitis B infection accepting regular antiviral treatment.Conclusion Female were more seen in SLE with non biliary cirrhosis and the condition were usually severe.These patients had a bad prognosis as a whole.A large majority of people were first diagnosed as SLE because of cirrhosis,and often they had worse prognosis.Hepatic encephalopathy,renal insufficiency,high bilirubin,largely elevated CA125 and CA199 may suggest a bad result.Accepting regular treatment of SLE with a SLE history and antiviral treatment with a definite hepatitis B virus infection may improve the prognosis.

关 键 词：系统性红斑狼疮 肝硬化 非原发性胆汁性肝硬化 乙肝 肝癌 

分 类 号：R593.241[医药卫生—内科学] R575.2[医药卫生—临床医学]