免疫抑制治疗系统性红斑狼疮时并发带状疱疹15例临床分析

Clinical Analysis of 15 Cases of Herpes Zoster Complicated in SLE Patients Treated with Immunosuppressive Therapy

目的 探讨免疫抑制治疗系统性红斑狼疮时并发带状疱疹的临床表现、诊断及治疗方法.方法分析15例患者经免疫抑制治疗系统性红斑狼疮时并发带状疱疹的临床治疗情况.结果 15例SLE患者中狼疮性肾炎患者11例,溶血性贫血患者3例,血小板减少患者4例,肺间质病变患者1例,大量心包积液患者1例.带状疱疹中寻常型12例、大疱型2例、坏死型1例.带状疱疹发病时,肾上腺皮质激素用量平均35.60±10.43mg/d,使用CTX的患者10例、MTX2例、MMF1例、Aza1例、LEF1例.对15例患者,均减少肾上腺皮质激素用量,暂时停用免疫抑制剂,加用阿昔洛韦静脉给药.结论 带状疱疹是免疫抑制治疗系统性红斑狼疮时常见的并发症,一般预后良好.

OBJECTIVETo study the clinical manifestations、diagnosis and treatment of herpes zoster complicated in SLE patients treated with immunosuppressive therapy. METHOD15 patients of the above condition were analyzed retrospectively. RESULTS11 cases of lupus erythematous nephritis、3 cases of hemolytic anemia、4 cases of thrombocytopenia、one case of interstitiual pneumonic disease、one case of diffused hydropericardium were found in the 15 cases of SLE patients. 12 cases were ordinary type、2 cases were bullae type、one case was necrosis type herpes zoster. In the onset of herpes zoster the mean dose of corticosteroid 35.60±10.43 mg/day and immunosuppressants were used in all patients, including CTX 10 cases、MTX 2 cases、MMF 1 case、Azathoprine 1 case、and LEF 1 case. After the onset of herpes zoster the dose of corticosteroids was decreased, immunosuppressant was ceased and anti-virus drug, acyclovir, was used. CONCLUSION These results suggest that herpes zoster was complicated with SLE patients frequently, it may be treated with immunosuppressant, generally the prognosis is good.