晚发型系统性红斑狼疮临床特点分析—单中心回顾性研究

发布时间：2018-07-06 08:05

  本文选题：晚发型 + 系统性红斑狼疮　； 参考：《广西医科大学》2015年硕士论文

【摘要】：目的：探讨晚发型系统性红斑狼疮患者的临床表现、实验室检查结果、肾脏病理特点及疗效。方法：选取230例年龄≥50岁的系统性红斑狼疮患者作为研究对象,称为晚发组,其中有67例行肾活检术；并随机选取同期349例年龄50岁的系统性红斑狼疮患者作为对照,称为早发组,其中134例行肾活检术。回顾性分析及比较两组系统性红斑狼疮患者的临床表现、实验室检查结果、肾脏病理及治疗效果。结果：较之早发组,晚发组中男性比例增加。晚发组白细胞减少的发生率高于早发组(P0.05)。面部红斑、光过敏、脱发、低补体血症、肾损害的发生率、特异性抗体的阳性率及SLEDAI评分低于早发组(P0.05)。两组肾脏病理分型之间差异有统计学意义(P=0.021),晚发组肾损害以Ⅲ型多见,早发组以Ⅳ型多见。与早发组比较,晚发组细胞增生、白细胞浸润、核碎裂／坏死程度较轻(P0.05),间质炎细胞浸润、肾小球硬化、肾小管萎缩、肾间质纤维化程度较重(P0.05),慢性指数高(P0.001),活动指数两组无显著差异(P=0.312)。部分行肾穿且随访时间≥6个月的晚发型系统性红斑狼疮患者,完全缓解率为36%,治疗有效率为84%。结论：1.晚发型系统性红斑狼疮患者症状不典型,特异性抗体出现率低,易误诊、漏诊。2.晚发型系统性红斑狼疮患者肾脏病变以慢性为主,病理类型较轻,以Ⅲ型多见。3.晚发型系统性红斑狼疮患者肾脏受累明显时,激素联合免疫抑制剂效果良好。
[Abstract]:Objective: to investigate the clinical manifestations, laboratory findings, renal pathological features and efficacy of late onset systemic lupus erythematosus. Methods: a total of 230 patients with systemic lupus erythematosus (SLE) aged more than 50 years were selected as study subjects, including 67 patients with renal biopsy, and 349 patients with systemic lupus erythematosus (SLE) aged 50 years. Called early onset group, 134 of them underwent renal biopsy. The clinical manifestations, laboratory findings, renal pathology and therapeutic effects of two groups of patients with systemic lupus erythematosus were retrospectively analyzed and compared. Results: compared with early onset group, the proportion of male in late onset group increased. The incidence of leukopenia in late onset group was higher than that in early onset group (P 0.05). The incidence of erythema, light allergy, alopecia, hypocomplement, renal damage, positive rate of specific antibody and SLEDAI score were lower than those in early onset group (P0.05). There was significant difference between the two groups in renal pathological classification (P0. 021). Type 鈪，

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