中华皮肤科杂志 ›› 2001, Vol. 30 ›› Issue (1): 12-14.

• 论著 • 上一篇    下一篇

伴雷诺现象的系统性红斑狼疮42例分析

林俊, 刘湘源, 黄次波, 黄烽   

  1. 解放军总医院风湿科, 北京 100853
  • 收稿日期:2000-02-21 出版日期:2001-02-15 发布日期:2001-02-15

Clinical Analysis of 42 Cases of Systemic Lupus Erythematosus With Raynaud’s Phenomenon

LIN Jun, LIU Xiangyuan, HUANG Cibo   

  1. Department of Rheumatology, General Hospital of PLA, Beijing 100853
  • Received:2000-02-21 Online:2001-02-15 Published:2001-02-15

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摘要：

目的 了解伴雷诺现象(RP)的系统性红斑狼疮(SLE)患者的临床特征.方法 对近4年在我院住院的42例伴RP的SLE患者进行临床分析,并与116例无RP的SLE患者进行对照.结果 与无RP组相比,有RP组出现脱发、肌炎/肌病、心脏受累和肺动脉高压的几率明显增高(分别为56.90%～83.33%,9.48%～23.81%,29.31%～59.52%,1.72%～21.43%,P<0.05或0.01).γ－球蛋白升高,抗核抗体、抗RNP及抗Sm抗体的阳性率也明显增高(分别为50.52%～73.68%,68.47%～87.80%,24.04%～70.00%,7.69%～35.00%,P<0.05或0.01).而两组患者在肾炎、神经系统受累及血液系统受累的发生率差异无显著性(P均>0.05).对125例患者进行了平均2.15年的随访,其中包括全部的11例肺动脉高压患者,死亡3例,其中1例死于肺动脉高压并发右心衰竭(有RP组).结论 SLE患者出现雷诺现象提示较易发生肺动脉高压、心脏受累和免疫学异常,对伴雷诺现象的SLE患者应注意其心肺状态,以便早期诊断和治疗.

关键词: 雷诺病, 红斑狼疮,系统性

Abstract:

Objective To study the clinical features of the patients with systemic lupus erythematosus (SLE)with Raynaud's phenomenon. Methods The clinical manifestations and laboratory findings of 42 SLE patients with Raynaud's phenomenon were analyzed and compared with those of 116 SLE patients without Raynaud's phenomenon. Results As compared with SLE patients without Raynaud's phenomenon,the SLE patients with Raynaud's phenomenon were more likely to have myalgia/myopathy(9.48% vs 23.81%,P<0.05),alopecia(56.90% vs 83.33%,P<0.01),pulmonary hypertension(1.72% vs 21.43%,P<0.01),cardiac involvement(29.31% vs 59.52%,P<0.01),elevated serum level of gamma-globulin(50.52% vs 73.68%,P<0.05),positive antinuclear antibodies(68.47% vs 87.80%,P><0.05),positive anti-RNP antibodies (24.04% vs 70.00%,P<0.01)and positive anti-Sm antibodies(7.69% vs 35.00%,P<0.05). There were no significant differences in nephritis,neuropsychiatric and hematologic alterations between two groups. Among the 11 SLE patients with pulmonary hypertension,3 patients died and 1 of them died of secondary heart failure,during 26-month follow-up. Conclusions The Raynaud's phenomenon in SLE patients seems susceptible to pulmonary hypertension,cardiac involvement and immunologic abnormalities. The function of heart and lung and pulmonary hypertension should be paid attention to in these cases.

Key words: Ravnaud’s disease, Lupus erythematosus,systemic