摘要
目的通过分析狼疮肠系膜血管炎（LMV）患者的临床资料，提高对LMV的认识。方法回顾性分析30例LMV住院患者的临床表现、实验室检查及治疗情况等。结果（1）30例LMV患者中腹痛23例（76．7％），腹泻21例（70％），恶心和（或）呕吐20例（66．7％）；（2）28例合并其他系统损害，以狼疮性肾炎（24例）、血液系统（18例）为多见；并发输尿管肾盂积水10例，假性肠梗阻8例；（3）24例患者病情处于活动期（系统性红斑狼疮疾病活动指数≥10）；10例患者白细胞和（或）补体C，随病情进展呈进行性下降；（4）抗SSA、U1RNP抗体阳性率分别为55．6％（15／27）、51．9％（14／27）；（5）14例腹部CT示肠管壁“靶形征”或肠系膜血管“栅栏征”样改变；（6）27例患者加大糖皮质激素剂量后症状迅速改善。结论LMV临床表现以腹痛、腹泻、呕吐为主；LMV常与其他系统损害并存，多处于病情活动，为重症系统性红斑狼疮表现之一；白细胞或补体C3动态下降可能与LMV有关；抗SSA抗体、抗U1RNP抗体与LMV关系有待进一步研究；LMV对大剂量糖皮质激素治疗反应良好。
Objective To characterize the clinical characteristics of lupus mesenteric vasculitis （LMV）. Methods Analyzing the clinical, laboratory and treatment data of LMV patients hospitalized from 2002. 1.1 to 2007. 12. 31 retrospectively. Results （ 1 ） The three common manifestations were abdominal pain, diarrhea and vomit with the prevalence rate of 77% , 70% and 67% respectively. （2）The majority of LMV cases were active vital organ （28/30）, kidney （24/30） and hematological system （18/30） were the main organs of involvement. Ten patients had hydroureteronephrosis, and 8 patients had intestinal pseudo- obstruction at the same time. （3）Systemic lupus erythematosus disease activity index （SLEDAI） score was ≥10 in 80% （24/30） of patients. The progression of LMV was accompanied with new-onset leucopenia or worsening leucopenia or hypocomplementemia in 10 cases. （4） Blood antinuclear antibodies were positive in 27 patients detected, and anti-SSA antibody was positive in 15 （56%）, anti-U1RNP antibody was positive in 14 （52%）. （5）Fourteen cases had bowel wall thickening with target sign or mesenteric vessels with palisade or comb sign in contrast CT scan of abdomen. （6）Twenty-seven cases were treated with orally or intravenous medium to high dose steroid therapy and recovered from LMV. Conclusions （ 1 ） Abdominal pain, diarrhea and vomit were frequent manifestations of LMV patients. （2） LMV was one of the serious complications of systemic lupus erythematosus（ SLE）, and usually accompanied by active SLE in other organs. （3） A drop in the white blood cell count or complement C3 titer might be correlate with the occurrence of LMV. It needs to further investigate the relationship between LMV and the high positive rate of anti-SSA and anti-U1RNP antibody. （4） LMV patients responded well to intravenous high dose methylprednisolone.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2009年第2期136-139,共4页
Chinese Journal of Internal Medicine
关键词
红斑狼疮
系统性
狼疮肠系膜血管炎
Lupus erythematosus, systemic
Lupus mesenteric vasculitis
