本文選題：晚發(fā)型 + 系統(tǒng)性紅斑狼瘡��； 參考：《廣西醫(yī)科大學(xué)》2015年碩士論文

【摘要】：目的：探討晚發(fā)型系統(tǒng)性紅斑狼瘡患者的臨床表現(xiàn)、實(shí)驗(yàn)室檢查結(jié)果、腎臟病理特點(diǎn)及療效。方法：選取230例年齡≥50歲的系統(tǒng)性紅斑狼瘡患者作為研究對象,稱為晚發(fā)組,其中有67例行腎活檢術(shù)；并隨機(jī)選取同期349例年齡50歲的系統(tǒng)性紅斑狼瘡患者作為對照,稱為早發(fā)組,其中134例行腎活檢術(shù)�；仡櫺苑治黾氨容^兩組系統(tǒng)性紅斑狼瘡患者的臨床表現(xiàn)、實(shí)驗(yàn)室檢查結(jié)果、腎臟病理及治療效果。結(jié)果：較之早發(fā)組,晚發(fā)組中男性比例增加。晚發(fā)組白細(xì)胞減少的發(fā)生率高于早發(fā)組(P0.05)。面部紅斑、光過敏、脫發(fā)、低補(bǔ)體血癥、腎損害的發(fā)生率、特異性抗體的陽性率及SLEDAI評分低于早發(fā)組(P0.05)。兩組腎臟病理分型之間差異有統(tǒng)計(jì)學(xué)意義(P=0.021),晚發(fā)組腎損害以Ⅲ型多見,早發(fā)組以Ⅳ型多見。與早發(fā)組比較,晚發(fā)組細(xì)胞增生、白細(xì)胞浸潤、核碎裂／壞死程度較輕(P0.05),間質(zhì)炎細(xì)胞浸潤、腎小球硬化、腎小管萎縮、腎間質(zhì)纖維化程度較重(P0.05),慢性指數(shù)高(P0.001),活動指數(shù)兩組無顯著差異(P=0.312)。部分行腎穿且隨訪時間≥6個月的晚發(fā)型系統(tǒng)性紅斑狼瘡患者,完全緩解率為36%,治療有效率為84%。結(jié)論：1.晚發(fā)型系統(tǒng)性紅斑狼瘡患者癥狀不典型,特異性抗體出現(xiàn)率低,易誤診、漏診。2.晚發(fā)型系統(tǒng)性紅斑狼瘡患者腎臟病變以慢性為主,病理類型較輕,以Ⅲ型多見。3.晚發(fā)型系統(tǒng)性紅斑狼瘡患者腎臟受累明顯時,激素聯(lián)合免疫抑制劑效果良好。
[Abstract]:Objective: to investigate the clinical manifestations, laboratory findings, renal pathological features and efficacy of late onset systemic lupus erythematosus. Methods: a total of 230 patients with systemic lupus erythematosus (SLE) aged more than 50 years were selected as study subjects, including 67 patients with renal biopsy, and 349 patients with systemic lupus erythematosus (SLE) aged 50 years. Called early onset group, 134 of them underwent renal biopsy. The clinical manifestations, laboratory findings, renal pathology and therapeutic effects of two groups of patients with systemic lupus erythematosus were retrospectively analyzed and compared. Results: compared with early onset group, the proportion of male in late onset group increased. The incidence of leukopenia in late onset group was higher than that in early onset group (P 0.05). The incidence of erythema, light allergy, alopecia, hypocomplement, renal damage, positive rate of specific antibody and SLEDAI score were lower than those in early onset group (P0.05). There was significant difference between the two groups in renal pathological classification (P0. 021). Type 鈪，

本文編號：2102091