17例新生儿红斑狼疮临床分析  

Clinical analysis of 17 cases of neonatal lupus erythematosus

作　　者：申子云 李景 程秀永[1] Shen Ziyun;Li Jing;Cheng Xiuyong(Department of Neonatology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院新生儿科,450000

出　　处：《中国小儿急救医学》2023年第8期601-606,共6页Chinese Pediatric Emergency Medicine

摘　　要：目的总结新生儿红斑狼疮的临床特点,提高对该病的认识。方法对郑州大学第一附属医院2015年2月至2021年9月收治的17例新生儿红斑狼疮患儿的临床资料进行回顾性分析,并复习相关文献。结果17例患儿中,男9例,女8例。出现皮肤损害13例,心脏损害8例,其中房室传导阻滞4例,QT间期延长合并房性早搏1例,房间隔缺损3例,室间隔缺损1例,动脉导管未闭2例,心包积液1例,肺动脉高压1例,心功能不全2例。1例患儿同时出现皮肤损害及心脏传导阻滞。血液系统损害15例,肝胆系统损害11例。血清学指标中,抗ANA抗体阳性17例,抗SSA-60阳性12例,抗SSA-52阳性13例,抗SSB阳性7例,抗Sm阳性1例,抗RNP阳性3例。其中4例房室传导阻滞患儿抗SSA-60、抗SSA-52均为阳性。皮肤损害患儿多预后良好,仅1例遗留褐色瘢痕,1例Ⅱ°Ⅱ型房室传导阻滞患儿及1例QT间期延长合并房性早搏患儿复查心电图正常,2例仍存在Ⅲ°房室传导阻滞,另1例于1岁2个月安装起搏器,且遗留痉挛性脑瘫。患儿母亲共16例行血清学检测,产前发现结缔组织抗体异常10例,产后发现结缔组织抗体异常6例。结论新生儿红斑狼疮无显著性别差异,Ⅲ°房室传导阻滞难以逆转,心外损害患儿多预后良好。Objective To summarize the clinical features of neonatal lupus erythematosus(NLE)and improve the understanding of the disease.Methods The clinical data of 17 NLE neonates admitted to the First Affiliated Hospital of Zhengzhou University from February 2015 to September 2021 were retrospectively analyzed,and relevant literatures were reviewed.Results Of the 17 patients,nine were boys and eight were girls.There were 13 cases of skin damage and eight cases of heart damage,including four cases of atrioventricular block,one case of QT interval prolongation complicated with atrial premature beat,three cases of atrial septal defect,one case of ventricular septal defect,two cases of patent ductus arteriosus,one case of pericardial effusion,one case of pulmonary hypertension,and two cases of cardiac insufficiency.One case developed skin damage and heart block at the same time.There were 15 patients with blood system damage and 11 patients with hepatobiliary system damage.Among the serological indicators,17 cases were positive for anti-ANA antibody,12 cases were positive for anti-SSA-60,13 cases were positive for anti-SSA-52,seven cases were positive for SSB,one case was positive for Sm,and three cases were positive for RNP.Among them,four neonates with atrioventricular block were positive for anti-SSA-60 and anti-SSA-52.Most of the patients with skin lesions had good prognosis,and only one patient had brown scars,one neonate with second-degree typeⅡatrioventricular block and one neonate with QT interval prolongation combined with premature atrial contractions had normal electrocardiograms.Additionally,two patients still had third-degree atrioventricular block,and the other one patient was installed with a pacemaker at one year and two months,and left spastic cerebral palsy.A total of 16 mothers had serological tests,among which ten cases had abnormal connective tissue antibodies before delivery and six cases had abnormal connective tissue antibodies after delivery.Conclusion There is no significant gender difference in N

关 键 词：红斑狼疮 狼疮综合征 新生儿 房室传导阻滞 

分 类 号：R722.1[医药卫生—儿科]