摘要
目的:分析系统性红斑狼疮(systemic lupus erythematosus,SLE)合并假性肠梗阻(intestinal pseudo-obstruction,IPO)患者的临床病例资料,提高临床医生尤其是消化内科及外科医生对本病的认识.方法:收集8例SLE合并肠梗阻患者的临床资料,并对其临床表现、辅助检查、治疗及预后等特点进行回顾性分析.结果:8例患者中男1例,女7例,发病年龄20-52岁,平均35岁,平均病程36mo.以肠梗阻为首发症状者2例(2/8),入院前被误诊为急性肠炎和溃疡性结肠炎.8例患者中肾脏累及者6例(6/8),血液系统累及者5例(5/8),皮肤病变5例(5/8),循环系统累及者4例(4/8),胆囊炎4例(4/8),消化道出血4例(4/8),腹水4例(4/8),中枢神经系统累及者1例(1/8).8例患者中抗核抗体(+)8例(8/8),抗dsDNA抗体(+)6例(6/8),所有病例均有补体水平下降及血沉升高(8/8).8例患者中6例使用糖皮质激素治疗均好转出院,死亡2例,1例并发肠穿孔死亡,1例行剖腹探查并部分小肠切除术,术后死亡.结论:IPO是SLE严重的并发症之一,常伴有其他脏器受累,免疫学检查多有异常.早期诊断并及早使用肾上腺糖皮质激素干预治疗对于控制病情及改善预后很重要,可避免不必要的手术治疗.
AIM： To analyze the clinical data for patients with systemic lupus erythematosus （SLE） with intestinal pseudo-obstruction （IPO） to improve the understanding of this condition. METHODS： The clinical data for eight patients with SLE with IPO were retrospectively reviewed to analyze the clinical manifestations, auxiliary examination, therapy and prognosis of this disease. RESULTS： There were 1 male and 7 females. The average age at the onset of disease was 35 years （range 20-52）. The average course from initiation of clinical symptoms to diagnosis was 36 mo. Two patients with intestinal obstruction as the first presentation were misdiagnosed with ulcerative colitis and enteritis, respectively. Six （6/8） cases had renal involvement, 5 （5/8） had hematological system involvement, 5 （5/8） had skin abnormality, and 4 （4/8） had cardiovascular system involvement. Four （4/8） cases had cholecystitis, 4 （4/8） had gastrointestinal bleeding, 4 （4/8） had ascites, and 1 （1/8） had central nervous system involvement. All cases （8/8） were positive for ANA and had hypocomplementemia and higher erythrocyte sedimentation rate. Six （6/8） cases were positive for anti-dsDNA. Glucocorticoid was used for therapy in 6 （6/8） cases and all of them got recovered. There were 2 （2/8） deaths, one for intestinal perforation and the other for surgical intervention. CONCLUSION： IPO is one of the most serious complications of SLE, which is usually associated with multisystem involvement. People with SLE would encounter with abnormalities in immunologic tests. Early diagnosis and timely use of glucocorticoid are of great importance in controling the disease, improving prognosis, and avoiding inappropriate surgical intervention.
出处
《世界华人消化杂志》
CAS
北大核心
2013年第10期945-950,共6页
World Chinese Journal of Digestology
基金
国家自然科学基金资助项目
No.81160376
广西壮族自治区卫生厅课题基金资助项目
No.Z2010303~~
关键词
红斑狼疮
系统性
假性肠梗阻
Lupus erythematosus
Systemic
Intestinal pseudo-obstruction
