系统性红斑狼疮患者的血液学异常及治疗

Hematological abnormality and treatment in systemic lupus erythematosus

目的:探讨系统性红斑狼疮(SLE)患者的血液学异常变化及其对药物治疗的反应。方法:对142例SLE患者外周血、骨髓象及应用糖皮质激素、免疫抑制剂治疗后变化情况进行总结分析。结果:142例中血象异常者121例,以血液学异常为首发症状就诊者32例(26.45%),其中误诊为血液系统疾病9例(7.44%)。在142例中45例行骨髓细胞学检查,发现骨髓增生活跃或明显活跃35例(77.78%),增生低下者10例(22.22%)。结论:SLE易累及血液系统,其特点是血液学改变多样性,缺乏特异性,容易误诊漏诊。SLE患者经糖皮质激素及免疫抑制剂治疗,其外周血和骨髓象均有不同程度的改善。

Objective： To analyze the hematological abnormality in systemic lupus erythematosus （SLE）. Methods： The blood and bone marrow pictures before and after treatment with steroids and immunosupressive agents were analyzed in 142 patients with SLE. Results： Out of 142 patients, 121 had hematological abnormalities. Of the 121 patients 32 （26.45 % ） presented with hematological abnormalities as the first presentation, including 9 （7.44%） cases who were misdiagnosed as hematological disorders. In 45 out of 142 patients, the bone marrow examination showed abnormilities including hyperplasia in 35 patients and hypoplasia in 10 patients. Conclusion： Hematological abnormalities are common in SLE patients, which are characterized as various profiles, but lack of specificity and easier to be misdiagnosed. The hematological and bone marrow abnormalities can be improved to some degree after treatment with steroid and immunosupressive agents.