系统性红斑狼疮患者实验室检查与病情活动及感染的关系

Relationship of serological features with disease status and infection in patients with systemic upus erythematosus(SLE)

目的：通过分析SLE病情活动和／或伴感染患者的临床和血清学特点，寻找对疾病活动和感染有鉴别意义的实验室指标。方法：2000—2004年我科住院359例SLE患者的回顾性分析，比较无感染病情活动者233例（SLE无感染组）和伴感染者126例（SLE伴感染组）的临床表现及相关实验室检测的变化。结果：感染组患者发热、口腔溃疡、雷诺现象、浆膜炎及心、肾、肝损害等临床表现的发生率及中性白细胞分类、C-反应蛋白（CRP）、ESR、α1球蛋白及尿β2-MG、尿IgG、尿α2-MG等均明显高于无感染组（P〈0．01）。通过比较多种实验室相关指标发现，CRP受感染外因素影响较少，无感染组患者CRP均数正常，伴感染则明显升高。结论：①SLE伴感染时多数患者CRP可明显升高；②SLE患者病情活动时CRP大多正常或轻度增高，但少数（尤其有浆膜炎者）CRP可呈较高水平。因此，CRP对于鉴别SLE病情活动与是否伴感染具有重要临床应用价值。

Objective： To investigate the relationship of serological features with the disease status and infection complication in patients with systemic lupus erythematosus （SLE）. Methods： From 2000 to 2004, 359 patients with SLE hospitalized in our hospital were retrospectively analyzed, and the clinical symptoms and laboratory features were reviewed. Results： The symptoms including fever, oral ulcer, Raynaudg phenomenon, oromeningitis and cardiac, renal, hepatic involvement in infection group were more common than those in disease flare group （P 〈 0. 01 ）. In infection group, the levels of ESR, C - reactive protein （ CRP.）, α1 globulin, urine, β2 - microglobulin, urine IgG and urine α2 - microglobulin were significantly higher than those in disease flare group （ P 〈0.01 ）. Furthermore, the CRP levels were mostly correlated with the infections of SLE. Conclusion： CRP may be a good marker to distinguish infection complications and disease status in SLE.