儿童狼疮性肺损伤8例临床分析

发布时间：2018-07-28 15:30

【摘要】：目的分析儿童狼疮性肺损伤的临床特点。方法回顾分析2011年1月至2015年12月收治的8例以呼吸系统受累为首发表现的系统性红斑狼疮(SLE)患儿的临床资料。结果 8例患儿的年龄6~15岁,男女各4例,均有咳嗽表现,发热7例,气促5例,咳痰5例,咯血3例,胸痛3例,呼吸困难3例,紫绀3例。狼疮性肺损伤类型分别为胸腔积液5例(62.5%)、急性狼疮性肺炎4例(50.0%)、慢性间质性肺炎2例(25.0%)、肺出血2例(25.0%);其中7例患儿胸部高分辨CT检查主要有磨玻璃样影5例、胸腔积液5例、纵膈或淋巴结肿大5例、节段性肺实变4例。7例患儿经治疗原发病后呼吸系统症状及肺部影像改变迅速好转,1例合并肺出血者死亡。结论以呼吸系统受累为首发症状的SLE患儿临床表现缺乏特异性,易与呼吸系统感染混淆,但多合并其他脏器受累;胸部影像学以磨玻璃样影、节段性肺实变、胸腔积液多见。
[Abstract]:Objective to analyze the clinical features of lupus lung injury in children. Methods the clinical data of 8 cases of systemic lupus erythematosus (SLE) with respiratory system involvement were retrospectively analyzed from January 2011 to December 2015. Results the age of 8 cases was 615 years old, male and female were 4 cases, all had cough, fever 7 cases, shortness of breath 5 cases, expectoration 5 cases, hemoptysis 3 cases, chest pain 3 cases, dyspnea 3 cases, cyanosis 3 cases. The types of pulmonary injury were pleural effusion in 5 cases (62.5%), acute lupus pneumonia in 4 cases (50.0%), chronic interstitial pneumonia in 2 cases (25.0%) and pulmonary hemorrhage in 2 cases (25.0%). Mediastinal or lymphadenomegaly in 5 cases, segmental pulmonary consolidation in 4 cases (7 cases). After treatment, respiratory symptoms and pulmonary imaging changes improved rapidly in 1 case with pulmonary hemorrhage. Conclusion the clinical manifestations of SLE patients with respiratory system involvement as the first symptom are lack of specificity and are easily confused with respiratory system infection, but most of them are complicated with other organ involvement, and the chest imaging features are glass-like, segmental pulmonary consolidation, pleural effusion and pleural effusion.
【作者单位】：重庆医科大学附属儿童医院儿童发育疾病研究教育部重点实验室儿科学重庆市重点实验室认知发育与学习障碍转化医学重庆市重点实验室;
【基金】：国家临床重点专科建设项目资助(No.2011-873)
【分类号】：R725

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