1例系统性红斑狼疮相继并发大腿结核、利福平耐药肺结核及深静脉血栓病例报道及文献复习  

A case report and literature review of systemic lupus erythematosus complicated with thigh tuberculosis,rifampin-resistant pulmonary tuberculosis and deep vein thrombosis

作　　者：唐玲[1] 唐阳 谭佳容 廖小刚 李同心[3] 杨松[4] Tang Ling;Tang Yang;Tan Jiarong;Liao Xiaogang;Li Tongxin;Yang Song(Department of Orthopaedics,Chongqing Public Health Medical Center,Chongqing 400036,China;Department of Nursing,Chongqing Public Health Medical Center,Chongqing 400036,China;Central Laboratory,Chongqing Public Health Medical Center,Chongqing 400036 China;Department of Elderly Tuberculosis&Comprehensive Internal Medicine,Chongqing Public Health Medical Center,Chongqing 400036,China)

机构地区：[1]重庆市公共卫生医疗救治中心骨科,重庆400036 [2]重庆市公共卫生医疗救治中心护理部,重庆400036 [3]重庆市公共卫生医疗救治中心中心实验室,重庆400036 [4]重庆市公共卫生医疗救治中心老年结核病综合内科,重庆400036

出　　处：《新发传染病电子杂志》2025年第1期86-90,共5页Electronic Journal of Emerging Infectious Diseases

基　　金：2024年重庆市科卫联合医学科研项目(2024MSXM061)。

摘　　要：系统性红斑狼疮(systemic lupus erythematosus,SLE)是一种自身免疫性疾病,其治疗方案常涉及激素类药物和环磷酰胺、甲氨蝶呤等免疫调节剂。这些药物会导致患者自身免疫力减弱,增加罹患感染性疾病的风险,尤其是结核分枝杆菌的感染风险。本文报道1例SLE患者在抗结核治疗过程中并发利福平耐药肺结核(rifampicin-resistant pulmonary tuberculosis,RR-PTB)、大腿结核及深静脉血栓(deep vein thrombosis,DVT),对患者的临床特征、诊治与护理经验等进行回顾性分析。患者入院后通过多学科诊疗(multi-disciplinary treatment,MDT),采用早期精准抗结核治疗、血管介入治疗、术后康复及护理等综合措施,病情得到有效控制。经3个月门诊随访,患者结核病病情好转,血栓无复发。通过文献复习总结了SLE合并结核病及DVT的危险因素,强调早期诊断和规范治疗的重要性。本文病例提示,应警惕SLE患者并发多种疾病的可能,MDT及护理有助于改善患者预后。Systemic lupus erythematosus(SLE),as an autoimmune disease,is commonly treated with a standard regimen that includes corticosteroids and immunomodulatory agents such as cyclophosphamide and methotrexate.These medications can weaken the patient's immune system,thereby increasing the risk of infectious diseases,particularly infection with Mycobacterium tuberculosis.This article reports a case of a patient with SLE who developed rifampicin-resistant pulmonary tuberculosis(RR-PTB),thigh tuberculosis,and deep vein thrombosis(DVT)during anti-tuberculosis treatment.A retrospective analysis of the patient's clinical characteristics,diagnosis,treatment,and nursing experience is presented.The patient's condition was effectively controlled through a multidisciplinary treatment approach,including early and precise anti-tuberculosis treatment,vascular intervention,postoperative rehabilitation,and nursing care.After 3 months of outpatient follow-up,the patient's tuberculosis improved and there was no recurrence of the thrombosis.A review of the literature summarized the risk factors for SLE combined with tuberculosis and DVT,emphasizing the importance of early diagnosis and standardized treatment.This case highlights the need to be vigilant for the possibility of multiple diseases in SLE patients,and the benefits of a multidisciplinary approach to diagnosis,treatment,and nursing care in improving patient prognosis.

关 键 词：系统性红斑狼疮 利福平耐药肺结核 大腿结核 深静脉血栓 文献复习 

分 类 号：R521[医药卫生—内科学] R519[医药卫生—临床医学]