摘要
目的分析系统性红斑狼疮（systemic lupus erythematosus,SLE）合并肺出血患者的临床特点,提高对该病的认识。方法收集本院风湿科2008年12月-2015年3月收治的SLE合并肺出血患者的临床资料,分析其病例特点并进行文献复习。结果共收集8例患者,男性2例,女性6例,平均年龄34（15~56）岁,平均病程30（2~96）个月。临床均表现为咯血或痰中带血、低氧血症、贫血和肺部弥漫性浸润影。8例中,肾损害6例,血液系统受累4例,肺间质病变2例,肺动脉高压1例,均无中枢神经系统受累,平均SLEDAI积分为6.6分。患者均接受了大剂量激素冲击治疗和人免疫球蛋白治疗,接受免疫抑制剂治疗5例。3例治疗无效死亡。结论肺出血是SLE较少见并发症,可发生于疾病的任何阶段,预后较差。
Objective To analyze the clinical features of systemic lupus erythematosus（SLE） patients complicated with diffuse alveolar hemorrhage（DAH）. Methods Clinical data about SLE patients complicated with DAH admitted to the department of rheumatology in our hospital from December 2008 to March 2015 were retrospectively analyzed and its related literatures were reviewed. Results The average age of the 8 SLE patients（2 males and 6 females） complicated with pulmonary hemorrhage included in this study was 34 years. And the mean course of disease was 30 months. All these patients presented with hemoptysis, blood in sputum, hypoxemia, anemia, and new infiltrates on chest CT scan. There were 6 cases with lupus nephritis, 4 with leukopenia or thrombocytopenia, 2 with pulmonary interstitial fibrosis, 1 with pulmonary hypertension and no lupus encephalopathy was found. The mean systemic lupus erythematosus disease activity index（SLEDAI） was 6.6. All patients received steroid pulse therapy together with intravenous immunoglobulin, and 5 of them received immunosuppressor. Three patients died. ConclusionDAH is a rare and catastrophic event in SLE. DAH can occur at any stage of the disease course. Early aggressive management with high-dose steroids may improve the prognosis of DAH.
出处
《解放军医学院学报》
CAS
2015年第11期1068-1070,1074,共4页
Academic Journal of Chinese PLA Medical School
关键词
红斑狼疮
系统性
肺出血
lupus erythematosus
systemic
pulmonary hemorrhage
hormone therapy
