本文選題：兒童 + 系統(tǒng)性紅斑狼瘡��； 參考：《寧夏醫(yī)科大學》2014年碩士論文

【摘要】：第一部分：兒童系統(tǒng)性紅斑狼瘡首發(fā)表現(xiàn) 目的對兒童系統(tǒng)性紅斑狼瘡首發(fā)表現(xiàn)進行百分比統(tǒng)計，提高診斷率。方法回顧性分析（2002年1月至2012年1月）59例住院治療SLE患兒，統(tǒng)計首發(fā)表現(xiàn)及檢驗、檢查結果。結果兒童系統(tǒng)性紅斑狼瘡最常見的首發(fā)表現(xiàn)是皮膚黏膜癥狀（66.10%），其他較為多見表現(xiàn)為發(fā)熱（37.29%）、乏力（27.12%），以及肌肉及關節(jié)疼痛（30.51%）、顏面或下肢浮腫（25.42%），，少見有抽搐等癥狀。結論兒童系統(tǒng)性紅斑狼瘡就診原因常為多行性的面部紅色皮疹、局部色素沉著，或雙手遇冷后色澤的改變，典型的蝶形紅斑及盤狀紅斑并不多見。經(jīng)常可有持續(xù)不明的發(fā)熱和歷史性的疲勞，較多能引起重視的癥狀則主要集中在四肢大關節(jié)疼痛及眼瞼、面部或雙下肢的腫脹。少數(shù)患兒可有各種急性起病癥狀。 第二部分：兒童系統(tǒng)性紅斑狼瘡臨床特點。 目的探討兒童系統(tǒng)性紅斑狼瘡病程中臨床特點，對疾病臨床診治提升依據(jù)。方法回顧性分析（2002年1月至2012年1月）59例住院治療SLE患兒，統(tǒng)計起病時、住院治療中、治療后存在的異常陽性臨床表現(xiàn)、檢驗檢查結果。結果兒童SLE發(fā)病年齡多在青春期，臨床表現(xiàn)以皮疹、發(fā)熱最為常見，器官系統(tǒng)損害以腎臟及血液系統(tǒng)多見，免疫學指標如dsDNA(74.58%)、ANA抗體譜（93.22%）陽性率高，除CRP外，各項指標在男女之間無差異性。結論不明原因的發(fā)熱和皮疹患兒，若存在多種自身抗體譜異�；蚨嘞到y(tǒng)損害者，應當警惕系統(tǒng)性紅斑狼瘡的可能。 第三部分：兒童系統(tǒng)性紅斑狼瘡治療前后SLEDAI評分及療效評估 目的分析兒童系統(tǒng)性紅斑狼瘡治療前后臨床癥狀的變化，對疾病療效進行判定。方法將上述59例患兒中規(guī)律我院進行治療，住院前后復診資料齊全者納入研究，符合條件的共計11例患兒，進行治療前后相關臨床表現(xiàn)、檢驗檢查結果統(tǒng)計，并行SLEDAI評分，比較前后差異。結果規(guī)律使用糖皮質激素和（或）免疫抑制劑治療后，所有患兒其SLEDAI評分較起病前有所降低，臨床癥狀和各項異常指標改善。結論糖皮質激素和（或）免疫抑制劑治療對于控制SLE的病情和改善預后有效。
[Abstract]:Part I: the first presentation of systemic lupus erythematosus in children
Objective to evaluate the initial performance of systemic lupus erythematosus (SLE) in children and improve the diagnostic rate. Methods Retrospective analysis (January 2002 to January 2012) 59 hospitalized children with SLE, the first presentation and examination, and the results. Results the most common manifestations of systemic lupus erythematosus in children were skin mucosal symptoms (66.10%), and other comparison. The symptoms were fever (37.29%), fatigue (27.12%), muscle and joint pain (30.51%), facial or lower extremity edema (25.42%) and rare convulsions. Conclusion the reasons for the treatment of systemic lupus erythematosus in children are often multiline facial red rash, local pigmentation, or color changes after cold hands, Typical Butterfly erythema and Discoid erythema is not common. It often has unidentified fever and historical fatigue. The symptoms of more attention are mainly concentrated in the pain and eyelids of the large joints of the limbs and the swelling of the face or lower limbs. A few children have various acute onset symptoms.
The second part: the clinical characteristics of children with systemic lupus erythematosus.
Objective to investigate the clinical characteristics of systemic lupus erythematosus in children and to improve the clinical diagnosis and treatment of the disease. Methods Retrospective analysis (January 2002 to January 2012) 59 cases of hospitalized children with SLE, statistical onset, hospitalization, after treatment, the existence of abnormal positive clinical table, test results. Results children SLE age is more than Puberty, the most common clinical manifestation is rash, fever is the most common, organ system damage is more common in the kidney and blood system. Immunological indexes such as dsDNA (74.58%), ANA antibody spectrum (93.22%) have high positive rate, except CRP, the indexes are no difference between men and women. Patients with multiple system injuries should be alert to the possibility of systemic lupus erythematosus.
The third part: SLEDAI score and curative effect evaluation of children with systemic lupus erythematosus before and after treatment.
Objective to analyze the changes of clinical symptoms before and after the treatment of systemic lupus erythematosus (SLE) in children, and to determine the effect of the disease. Methods the 59 cases of the children were treated in our hospital, and the data of the patients were included in the study before and after the hospitalization. The total of 11 cases were in accordance with the conditions, and the clinical manifestations before and after the treatment were carried out, and the results were checked and the results were checked and the results were checked. After the treatment of glucocorticoid and (or) immunosuppressant, the SLEDAI score of all children was lower than that before the onset, and the clinical symptoms and various abnormal indexes were improved. Conclusion the treatment of glucocorticoid and / or immunosuppressive agents was effective in controlling the condition of SLE and improving the prognosis of the SLEDAI.
【學位授予單位】：寧夏醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R725.9

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