以消化系统症状为首发表现的系统性红斑狼疮与克罗恩病的临床特征比较

Analysis of clinical features of Crohn's disease and systemic lupus erythematosus presenting symptoms of digestive system as initial manifestation

目的 比较以消化系统症状为首发表现的系统性红斑狼疮(SLE)与克罗恩病(CD)的临床特征.方法 选取以不明原因腹痛、腹泻等消化系统症状为主诉并最后确诊为SLE者为研究对象,并按1∶2比例随机选取同期收入住院的CD患者为对照组,对两组进行比较分析.结果 收集到以消化系统症状为首发表现的SLE患者(SLE组)31例,对照组CD患者(CD组)62例.CD组腹痛(P=0.014)、腹泻(P=0.016)、发热(P=0.018)及血便(P=0.000)症状较SLE组多见;而SLE组腹胀(P=0.001)及恶心、呕吐(P=0.000)症状较CD组多见.CD组白细胞(P=0.032)、血小板(P=0.000)、血清白蛋白(P=0.032)水平及大便隐血阳性率(P=0.007)较SLE组高.SLE组天门冬氨酸氨基转移酶(P=0.000)、丙氨酸氨基转移酶(P=0.000)水平高于CD组,且补体C3水平(P=0.000)降低更为明显.结论 临床上应注意鉴别以消化系统症状为首发表现的SLE与CD的临床特征,以减少误诊、漏诊.

Objective To compare the clinical features of Crohn's disease (CD) and systemic lupus erythematosus (SLE) presenting symptoms of digestive system as initial manifestations. Methods Patients with SLE presenting to our department with symptoms of digestive system such as abdominal pain and diarrhea as initial manifestations were analyzed retrospectively. During the same period, control group. Results A total of 31 SLE patients presenting symptoms of digestive system as initial manifestations were collected. Sixty-two patients with CD were selected. The symptoms of abdominal pain (P=0.014), diarrhea (P=0.016), fever (P=0.018) and hematochezia (P=0.000) were more frequent in patients with CD than those in patients with SLE. But the symptoms of bloating (P=0.001), nausea and vomiting (P=0.000) were more frequent in patients with SLE as compared to patients with CD. The levels of white blood cell (P=0.032), platelets (P=0.000) and serum albumin (P=0.032) were higher in patients with CD than those in patients with SLE. The proportion of positive stool occult blood test (P=0.007) was also higher in patients with CD than that in patients with SLE. However, the levels of AST (P=0.000) and ALT (P=0.000) were higher and the level of C3 (P=0.000) was lower in patients with SLE as compared to patients with CD.Conclusions The clinical features of SLE presenting symptoms of digestive system as initial manifestation should be differentiated from CD by physicians to facilitate correct diagnosis.