晚发系统性红斑狼疮102例临床分析.docVIP

晚发系统性红斑狼疮102例临床分析 【摘要】 目的 探讨晚发系统性红斑狼疮(SLE)的临床特征。 方法 收集晚发SLE(发病年龄≥50岁)102例和同期早发SLE(发病年龄＜50岁)415例患者资料，比较 分析 两组的临床表现、实验室指标。结果 晚发SLE占所有SLE患者的19.7%。其中女男为5.381，明显低于早发组(女男为11.21)，差异有统计学意义(P＜0.01)。晚发组发病到确诊的平均时间长，疲乏、关节痛、体重下降、肌痛肌无力、肺部病变发生率高，肾损害、雷诺现象、脱发的发生率低(P＜0.05)，血沉增快、肝功能损害检出率高，而补体(C3C4)降低、白蛋白降低、dsDNA阳性检出率低(P＜0.05)。结论 晚发SLE在临床表现及实验室检查等方面不典型，在临床诊治中应给予足够重视。 【关键词】 系统性红斑狼疮；晚发；临床特征 　 　　Abstract: Objective To investigate the clinical characteristics of late-onset systemic lupus erythematosus（SLE）.Methods Clinical and laboratory information of 102 patients with late-onset SLE( aged 50 and above)and 415 patients with early-onset SLE(aged below 50 years)were collected and compared. Results The late-onset SLE patients accounted for19.7% of the homochronous admission SLE cases.The ratio of female to male in the late-onset SLE group was significantly lower than that in early-onset SLE group (P＜0.01). The average time from onset to diagnosis in the late-onset SLE group was longer than that in the early-onset group (P＜0.05). Fatigue,arthritis, wEight losing，muscular pain,weakness of the muscle and pneumonopathy in the late-onset group were significantly higher than that in the early-onset group. Renal damage，Raynauds phenomenon and baldness were significantly rarer in the late-onset group than that in the early-onset group (P＜0.05). The increase of ESR and liver function damage were significantly higher than that in the early group.But low complements C3C4 and the positive rates of antibody of anti-ds-DNA in late-onset group were significantly less frequent(P＜0.05) than that in early-onset group. Conclusion The late-onset SLE was atypical in clinical manifestation and immunology examination, so attention should be paid to these in clinical diagnosis and treatment. 　　Key words：systemic lupus erythematosus； late-onset；clinical characteristics 系统性红斑狼疮(systemic lupus erythematosus，SLE)是多系统多脏器受累的自身免疫病，多见于育龄期妇女，老年人少见。国内外学者常将50岁以后发病的系统性红斑狼疮称为晚发系统性红斑狼疮［1］(late onset systemic lupus erythemat