亚急性与慢性皮肤红斑狼疮的临床及免疫学特征比较  

作　　者：宣小芳 洪宝建[2] 苏丽韫[2] 

机构地区：[1]浙江中医药大学,310053 [2]浙江省人民医院,310014

出　　处：《浙江临床医学》2021年第3期349-352,共4页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划项目(2019KY290)。

摘　　要：目的比较亚急性皮肤红斑狼疮(SCLE)与慢性皮肤红斑狼疮(CCLE)的患病率和临床、免疫学特征。方法回顾性分析2017年1月至2019年12月598例皮肤红斑狼疮患者的临床资料,SCLE 275例,CCLE 323例,依据患者的住院电子病历对所有患者的临床和血清学检查结果相关信息进行采集、整理和比较,分析SCLE与CCLE的临床及免疫学实验室检查结果差异。结果临床特征方面,与CCLE患者相比,SCLE患者环形与丘疹鳞屑病变、雷诺现象、黏膜溃疡、蝶形斑、光敏感及血管炎的忠病率更高,盘状病变及脱发的几率则较低(P<0.05)。SCLE患者患有关节痛、干眼症、关节炎、肾病和系统性红斑狼疮的几率显著高于CCLE患者(P<0.O5)。SCLE患者的血清检查结果异常几率普遍更高(P<0.05),广泛盘状红斑狼疮(DLE)患者光敏感的患病率显著高于局部DLB患者(45.5%vs2.2%,P<0.001);SCLE患者中100例合并SLE,悲病率高于CCLE患者(36.4%vs5.6%,P<0.001),该组患者临床和免疫学数据间存在密切关联。结论SCLE与CCLE的表达差异与病变的位置和类型、系统特征及免疫学检查结果差异相关,SCLE患者皮肤病变的恋病率、系统特征及免疫学检查结果异常的几率显著高于CCLE,因此与系统性红斑狼疮更为接近。Objective To compare and analyze the prevalence and clinical and immunological characteristics of subacute(SCLE)and chronic cutaneous lupus erythematosus(CCLE).Methods The study period was from January 2017 to December 2019.A total of 598 patients with cutaneous lupus erythematosus were included as the research objects,with 275 cases of SCLE and 323 cases of CCLE.The clinical results of all patients based on the inpatient electronic records were collected,the information related to serological examination results was sorted and compared,and the differences in clinical and immunological laboratory examination results were analyzed between SCLE and CCLE.Results In terms of clinical features,compared with CCLE patients,SCLE patients had a higher prevalence of circular and papules scaly lesions,Raynaud’s phenomenon,mucosal ulcers,butterfly plaques,light sensitivity and vasculitis,and discoid lesions and hair loss.Low(P<0.05).SCLE patients were more likely to suffer from arthralgia,dry eye,arthritis,nephropathy,and systemic lupus erythematosus than CCLE patients(all P<0.05).The probability of abnormal serum test results in SCLE patients was generally higher(P<0.05),and the prevalence of photosensitivity in patients with extensive discoid lupus erythematosus(DLE)was significantly higher than that in patients with local DLE(45.5%vs 22.2%,P<0.001).In 100 SCLE patients,the prevalence of SLE was significantly higher than that of CCLE patients(36.4%vs 5.6%,P<0.001).There was a close correlation between clinical and immunological data of this group of patients.Conclusion The expression difference between SCLE and CCLE is related to the location and type of lesions,system characteristics and immunological examination results.The prevalence of skin lesions,system characteristics and immunological examination results of SCLE patients are significantly higher than that of CCLE.Systemic lupus erythematosus is closer.

关 键 词：红斑狼疮 亚急性 慢性 临床 免疫学检查 

分 类 号：R75[医药卫生—皮肤病学与性病学]