摘要
目的探讨系统性红斑狼疮(SLE)并发缺血性肠病(IBD)的诊治策略。方法对12例SLE并发缺血性肠病患者的临床特点、腹部螺旋CT扫描征象、实验室检查指标进行分析,并与30例不伴有腹部表现的SLE患者进行对比,并总结大剂量免疫球蛋白联合甲基强的松龙冲击对SLE并发缺血性肠病的效果。结果12例SLE并发IBD患者均有发热、腹痛、腹肌紧张、腹部反跳痛、肠鸣音减弱,但均非SLE的首发表现。SLE并发IBD患者腹部螺旋CT扫描显示两类异常征象:一类是肠壁异常,另一类是肠系膜水肿和血管增粗、增多以及异常的“梳状”或“栅栏样”血管排列。血补体C3及血白细胞计数较对照组明显降低,其他活动指标两组之间无显著差异。大剂量免疫球蛋白联合甲基强的松龙冲击治疗后IBD症状迅速缓解。结论临床特征结合腹部螺旋CT扫描可提高对SLE并发缺血性肠病的诊断符合率。SLE并发缺血性肠病多为腹部脏器小血管炎所致,多数不需要外科处理,及时给予免疫球蛋白联合甲基强的松龙冲击对缺血性肠病的效果明显。
Objective To investegate the dignosis and treatment strategies of ischemic bowel disease in systemic lupus erythematosus(SLE) patients.Methods The clinical feature,spiral CT imaging files and laboratorial outcome of 12 SLE patients combined with ischemic bowel disease and 30 SLE patients without ischemic bowel disease were retrospectively reviewed.The effects of pulse MP were also observed.Results Ischemic bowel disease was not the first sign in 12 SLE patients,5 cases with acute abdomens,4 with bowel lumen dilatations,other abnormal findings included peritonitis,pancreas inflammation and so on.There were two characters in the spiral CT imaging files:intestinal wall abnormity and mesenteric swelling with increased density of adipose tissue.Alexin C3 and the number of leucocyte were remarkably high in SLE patients combined with ischemic bowel disease.The clinical features in SLE patients combined with Ischemic bowel disease were ameliorated after the treatment of pulse MP.Conclusion The clinical features and spiral CT findings can increase the diagnosis ratio of ischemic bowel disease in SLE patients.The effect of pulse MP was remarkable in SLE patientscombined with ischemic bowel disease.
出处
《中国全科医学》
CAS
CSCD
2007年第12期992-994,共3页
Chinese General Practice
关键词
系统性红斑狼疮
缺血性肠病
计算机断层扫描
诊断/治疗
Systemic lupus erythematosus
Ischemic bowel disease
Computed tomography
Diagnosis/Therapy
