男性儿童与成人系统性红斑狼疮的临床分析

发布时间：2018-10-20 15:03

【摘要】：目的探讨男性儿童与成人系统性红斑狼疮(SLE)患者临床表现及实验室检测结果的差异性。方法选取宁夏医科大学总医院风湿免疫科2004年1月—2014年12月住院的150例男性SLE患者,其中儿童30例,成人120例。记录患者起病时及进展期的临床表现,包括:蝶形红斑、盘状红斑、消化系统受累、其他皮损、口腔溃疡、关节及肌肉受损、血管炎、血液系统受损、肾脏受累、光过敏、发热/疲劳、口干/眼干、心脏受累、雷诺现象、脱发。实验室检测指标包括:红细胞沉降率、血细胞、超敏C反应蛋白(hs-CRP)、肝功能、抗核抗体(ANA)、可溶性核蛋白抗体(抗Sm、SSA、SSB、U1RNP、Rib抗体)、抗脱氧核糖核酸抗体(抗ds-DNA抗体)、抗心磷脂抗体(ACA)、抗中性粒细胞胞质抗体(ANCA)、C3、C4、IgG、IgA及IgM。结果 SLE患者起病时儿童血管炎发生率、血液系统受损发生率、肾脏受累发生率、心脏受累发生率均高于成人(P0.05);起病时其余临床表现比较,差异无统计学意义(P0.05)。SLE患者进展期儿童消化系统受累发生率、关节及肌肉受损发生率、肾脏受累发生率、发热/疲劳发生率均低于成人(P0.05);进展期其余临床表现比较,差异无统计学意义(P0.05)。SLE患者中儿童ANA临界阳性率、抗SSA抗体阳性率均高于成人(P0.05);其余实验室检测指标比较,差异无统计学意义(P0.05)。男性儿童与成人SLE患者C3、C4、IgG、IgA、IgM水平比较,差异均无统计学意义(P0.05)。结论男性儿童SLE患者血管炎、肾脏受累发生率较高;男性儿童SLE患者出现ANA临界阳性或抗SSA抗体阳性时均应高度警惕SLE的可能性。
[Abstract]:Objective to investigate the difference of clinical and laboratory findings between male and adult patients with (SLE). Methods one hundred and fifty male SLE patients, including 30 children and 120 adults, were selected from the Department of Rheumatological Immunology, General Hospital of Ningxia Medical University from January 2004 to December 2014. Record the clinical manifestations of the patients at onset and progression, including: butterfly erythema, disc erythema, digestive system involvement, other skin lesions, oral ulcers, joint and muscle damage, vasculitis, impaired blood system, kidney involvement, light hypersensitivity, Fever / fatigue, dry mouth / eye, heart involvement, Renault phenomenon, hair loss. Laboratory tests included erythrocyte sedimentation rate, blood cells, hypersensitive C-reactive protein (hs-CRP), liver function, Anti nuclear antibody (ANA), soluble nucleoprotein antibody, anti deoxyribonucleic acid antibody (anti ds-DNA antibody), anti anticardiolipin antibody (ACA), anti neutrophil cytoplasmic antibody (ANCA), C 3N C 4 G A and IgM. Results the incidence of vasculitis, blood system damage, kidney involvement and heart involvement in children with SLE were higher than those in adults (P0.05). There was no significant difference (P0.05) the incidence of digestive system involvement, joint and muscle damage, kidney involvement, fever / fatigue in children with advanced). SLE were lower than those in adults (P0.05). There was no significant difference (P0.05). SLE patients in the critical positive rate of ANA, anti SSA antibody positive rate were higher than adults (P0.05); other laboratory indicators, the difference was not statistically significant (P0.05). There was no significant difference between male children and adult SLE patients (P0.05). Conclusion the incidence of vasculitis and renal involvement in male children with SLE is high, and the possibility of SLE should be highly alert when ANA critical positive or anti-SSA antibody is positive in male children with SLE.
【作者单位】：宁夏医科大学总医院医学实验中心;
【分类号】：R593.241;R725.9

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