59例儿童系统性红斑狼疮的临床分析

发布时间：2018-05-31 01:05

本文选题：儿童 + 系统性红斑狼疮　；参考：《宁夏医科大学》2014年硕士论文

【摘要】：第一部分：儿童系统性红斑狼疮首发表现目的对儿童系统性红斑狼疮首发表现进行百分比统计，提高诊断率。方法回顾性分析（2002年1月至2012年1月）59例住院治疗SLE患儿，统计首发表现及检验、检查结果。结果儿童系统性红斑狼疮最常见的首发表现是皮肤黏膜症状（66.10%），其他较为多见表现为发热（37.29%）、乏力（27.12%），以及肌肉及关节疼痛（30.51%）、颜面或下肢浮肿（25.42%），，少见有抽搐等症状。结论儿童系统性红斑狼疮就诊原因常为多行性的面部红色皮疹、局部色素沉着，或双手遇冷后色泽的改变，典型的蝶形红斑及盘状红斑并不多见。经常可有持续不明的发热和历史性的疲劳，较多能引起重视的症状则主要集中在四肢大关节疼痛及眼睑、面部或双下肢的肿胀。少数患儿可有各种急性起病症状。第二部分：儿童系统性红斑狼疮临床特点。目的探讨儿童系统性红斑狼疮病程中临床特点，对疾病临床诊治提升依据。方法回顾性分析（2002年1月至2012年1月）59例住院治疗SLE患儿，统计起病时、住院治疗中、治疗后存在的异常阳性临床表现、检验检查结果。结果儿童SLE发病年龄多在青春期，临床表现以皮疹、发热最为常见，器官系统损害以肾脏及血液系统多见，免疫学指标如dsDNA(74.58%)、ANA抗体谱（93.22%）阳性率高，除CRP外，各项指标在男女之间无差异性。结论不明原因的发热和皮疹患儿，若存在多种自身抗体谱异常或多系统损害者，应当警惕系统性红斑狼疮的可能。第三部分：儿童系统性红斑狼疮治疗前后SLEDAI评分及疗效评估目的分析儿童系统性红斑狼疮治疗前后临床症状的变化，对疾病疗效进行判定。方法将上述59例患儿中规律我院进行治疗，住院前后复诊资料齐全者纳入研究，符合条件的共计11例患儿，进行治疗前后相关临床表现、检验检查结果统计，并行SLEDAI评分，比较前后差异。结果规律使用糖皮质激素和（或）免疫抑制剂治疗后，所有患儿其SLEDAI评分较起病前有所降低，临床症状和各项异常指标改善。结论糖皮质激素和（或）免疫抑制剂治疗对于控制SLE的病情和改善预后有效。
[Abstract]:Part I: the first presentation of systemic lupus erythematosus in children
Objective to evaluate the initial performance of systemic lupus erythematosus (SLE) in children and improve the diagnostic rate. Methods Retrospective analysis (January 2002 to January 2012) 59 hospitalized children with SLE, the first presentation and examination, and the results. Results the most common manifestations of systemic lupus erythematosus in children were skin mucosal symptoms (66.10%), and other comparison. The symptoms were fever (37.29%), fatigue (27.12%), muscle and joint pain (30.51%), facial or lower extremity edema (25.42%) and rare convulsions. Conclusion the reasons for the treatment of systemic lupus erythematosus in children are often multiline facial red rash, local pigmentation, or color changes after cold hands, Typical Butterfly erythema and Discoid erythema is not common. It often has unidentified fever and historical fatigue. The symptoms of more attention are mainly concentrated in the pain and eyelids of the large joints of the limbs and the swelling of the face or lower limbs. A few children have various acute onset symptoms.
The second part: the clinical characteristics of children with systemic lupus erythematosus.
Objective to investigate the clinical characteristics of systemic lupus erythematosus in children and to improve the clinical diagnosis and treatment of the disease. Methods Retrospective analysis (January 2002 to January 2012) 59 cases of hospitalized children with SLE, statistical onset, hospitalization, after treatment, the existence of abnormal positive clinical table, test results. Results children SLE age is more than Puberty, the most common clinical manifestation is rash, fever is the most common, organ system damage is more common in the kidney and blood system. Immunological indexes such as dsDNA (74.58%), ANA antibody spectrum (93.22%) have high positive rate, except CRP, the indexes are no difference between men and women. Patients with multiple system injuries should be alert to the possibility of systemic lupus erythematosus.
The third part: SLEDAI score and curative effect evaluation of children with systemic lupus erythematosus before and after treatment.
Objective to analyze the changes of clinical symptoms before and after the treatment of systemic lupus erythematosus (SLE) in children, and to determine the effect of the disease. Methods the 59 cases of the children were treated in our hospital, and the data of the patients were included in the study before and after the hospitalization. The total of 11 cases were in accordance with the conditions, and the clinical manifestations before and after the treatment were carried out, and the results were checked and the results were checked and the results were checked. After the treatment of glucocorticoid and (or) immunosuppressant, the SLEDAI score of all children was lower than that before the onset, and the clinical symptoms and various abnormal indexes were improved. Conclusion the treatment of glucocorticoid and / or immunosuppressive agents was effective in controlling the condition of SLE and improving the prognosis of the SLEDAI.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R725.9

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