系统性红斑狼疮合并肠道病变的临床特征及诊治分析  

Clinical characteristics,diagnosis and treatment of systemic lupus erythematosus with intestinal lesions

作　　者：刘源[1] 彭孝倩 丁航 周琳[1] LIU Yuan;PENG Xiaoqian;DING Hang;ZHOU Lin(Department of Gastroenterology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院消化内科,河南郑州450052

出　　处：《胃肠病学和肝病学杂志》2021年第2期168-173,共6页Chinese Journal of Gastroenterology and Hepatology

基　　金：国家自然科学基金资助项目(81472325)。

摘　　要：目的分析系统性红斑狼疮(systemic lupus erythematosus,SLE)合并肠道病变患者的临床表现、实验室检查、CT、结肠镜表现及其预后等。方法回顾性分析2014年1月至2019年5月在郑州大学第一附属医院收治的SLE合并肠道病变的98例患者,归纳总结其临床特点。结果98例SLE合并肠道病变的患者最常见的临床表现为下腹痛(34.69%),合并肾脏系统与血液系统疾病多见。尿蛋白定性阳性在SLE合并单纯肠道病变与同时累及其他系统疾病之间的差异有统计学意义(P<0.05)。尿蛋白阳性、白蛋白降低、ESR升高在SLE合并肠系膜血管炎与合并蛋白丢失性肠病之间的差异有统计学意义(P<0.05)。影像学检查如CT、X线对于SLE合并肠道病变有一定诊断提示意义。SLE合并假性肠梗阻的预后相对更差。结论SLE合并肠道病变患者临床症状多样且不典型,特别是以肠道症状首发时鉴别困难,临床上应提高对其认识。Objective To analyze the clinical manifestations,laboratory examinations,CT,colonoscopy and the prognosis of systemic lupus erythematosus(SLE)with intestinal lesions.Methods Retrospective analysis was used to collect 98 cases of SLE with intestinal lesions patients in the First Affiliated Hospital of Zhengzhou University from Jan.2014 to May 2019,and their clinical characteristics were summarized.Results The most common clinical symptom of 98 cases of SLE with intestinal lesions patients were lower abdominal pain,accounting for 34.69%,and it was more common with kidney or blood system diseases.The qualitative positive urine protein was statistically significant between SLE combined with simple intestinal lesions and other diseases involving other systems(P<0.05).The difference of positive urine protein,decreased albumin and elevated ESR between SLE with lupus mesenteric vasculitis and protein-losing enteropathy were statistically significant(P<0.05).Imaging examinations such as CT and X-ray had certain diagnostic significance for SLE complicated with intestinal lesions.SLE with intestinal pseudo-obstruction had a relatively poorer prognosis.Conclusion The clinical symptoms of SLE with intestinal lesions patients are various and nontypical,it is difficult to identify when the initial symptoms are intestinal symptoms.It is necessary to improve the clinical awareness.

关 键 词：肠道病变 系统性红斑狼疮 肠系膜血管炎 蛋白丢失性肠病 

分 类 号：R593.241[医药卫生—内科学] R574[医药卫生—临床医学]