系统性红斑狼疮伴发急性胰腺炎19例临床分析..doc

系统性红斑狼疮伴发急性胰腺炎19例临床分析 梁碧琴 广西百色市人民医院肾内、风湿免疫科（百色533000）gxlbqin@163.com 【摘　要】 目的 探讨系统性红斑狼疮(SLE)伴发急性胰腺炎的临床特点、治疗方法和预后。方法　回顾性分析广西百色市人民医院2000～2008年收治的SLE伴发急性胰腺炎19例患者的临床资料。结果　(1)所有患者临床症状以腹痛、恶心、呕吐及腹胀为主，有多器官系统受损，平均有4.6 个器官系统受损，大多数患者伴有血白细胞或血小板减少及血C3、C4降低。(2)以急性胰腺炎首发占42.1%(8/19 )，容易误诊。（3)SLE病情活动患者给予中到大剂量糖皮质激素治疗,病情痊愈8例,好转6例,死亡5例。结论　(1) 急性胰腺炎是SLE 病情活动的表现；(2) 糖皮质激素不是导致胰腺炎的病因；（3) 中到大剂量糖皮质激素治疗是安全有效的；(4) 复发SLE伴发急性胰腺炎时，病情较重，死亡率高。 【关键词】　系统性红斑狼疮；急性胰腺炎； 临床分析 Clinical analysis of 19 cases of acute pancreatitis in systemic lupus erythematosus. Liang biqin. Department of nephrology and rheumatology, Baise prefectural hospital ,Baise Guangxi(533000)。 【Abstracts】 Objective To investigate the clinical features,treatment and prognosis of acute pancreatitis in patients with systemic lupus erythematosus (SLE). Methods From 2000 to 2008,19 SLE patients with acute pancreatitis were retrospectively analyzed. Results Abdominal pain, nausea, vomitting or distension were the main manifestations of acute pancreatitis due to SLE, it has the multi-organ system to suffer injury, has 4.6 organ systems to suffer injury equally. Most of the patients were accompanied with leucopenia and hypocomplementemia，accounts for 42.1% by the acute pancreatitis, easy to misdiagnose. The condition moves the patient received the treatment of moderate to large dosage of corticosteroids. Eight patients recovered. Six patients improved. Five patients died. Conclusion Acute pancreatitis occurs in the active stage of SLE. The corticosteroids may not be the cause of SLE pancreastitis. The treatment with moderate to high doses of corticosteroids is safe and effective. The recrudescence SLE with acute pancreatitis indicate serious condition, the mortality rate is high. Key words 　Systemic lupus erythematosus; Acute pancreatitis; Clinicalanalysis 　系统性红斑狼疮(systemiclu puser ythematosus, SLE) 是好发于中青年女性的自身免疫性疾病，可累及全身各器官系统。以急性胰腺炎为首发或主要表现的SLE患者，临床上易发生误诊或漏诊。为提高对SLE伴发急性胰腺炎的认识，现将2000～2008 年收治的412例SLE，其中伴发急性胰腺炎的19例进行总结分析。 1 材料与方法 1、1 一般资料