摘要
目的探讨狼疮肠炎患者的临床和实验室特点。方法对2004至2011年于中山大学附属第一医院住院并出现急性腹痛的系统性红斑狼疮患者进行分组对照研究，狼疮肠炎组66例，非狼疮本身相关腹痛组73例。研究因素包括患者人口数据、实验室数据、临床和影像学数据。结果狼疮肠炎是狼疮患者急性腹痛最常见原因，占39．3％（66／168）。在两组间自身抗体谱、补体、ESR、CRP、SLEDAI评分差异均无统计学意义。狼疮肠炎组的D—II聚体水平和ECLAM评分明显高于非狼疮本身所致腹痛组。狼疮肠炎组较非狼疮本身所致腹痛组明显更多合并多浆膜腔积液和腹水。经Logistic回归分析，仅D-Ⅱ聚体水平、ECLAM评分和腹水量的分级被回归方程接纳，为有意义的相关因素。结论狼疮肠炎是狼疮急性腹痛常见的原因；D-Ⅱ聚体水平是狼疮肠炎有意义的临床预测因素。相对于SLEDAI，ECLAM更适用于狼疮消化道损害患者的评估。
Objective To explore the clinical and laboratory characteristics of patients with lupus enteritis to provide rationales for clinical diagnosis and treatment. Methods A retrospective group control study was conducted for systemic lupus erythematosus （SLE） patients with complaints of acute abdominal pain from 2004 to 2011. They were divided into 2 groups：lupus enteritis （n = 66） and non-lupus related abdominal pain（ n =73 ）. The associated factors included demographic, laboratory, clinical and radiographic data. Results Lupus enteritis （39. 3 % ） was the most common cause of lupus patients with acute abdominal pain. There were no differences in autoantibody profiles, complement, erythrocyte sedimentation rate, C reactive protein and SLE disease activity index （SLEDAI） score between two groups. The level of D-dimer and European consensus lupus activity measurement （ECLAM） score were significantly higher in the group of lupus enteritis than those in non-lupus related gastrointestinal injury. Lupus enteritis had significantly higher percentage of complications with muhiple serous cavity effusions and ascites. But after adjusting with logistic regression multivariate analysis, only the level of D-dimer, ECLAM and volume of ascites were associated with occurrence of lupus enteritis. Conclusion Lupus enteritis is the most common cause of acute abdominal pain. D-dimer is an excellent predictor for lupus abdominal pain. As compared with SLEDAI, ECLAM may be more suitable for assessment in SLE patients with alimentary tract injury.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第15期1162-1164,共3页
National Medical Journal of China
基金
基金项目：广东省科技计划基金（20118080701011
20108080701099）
