系统性红斑狼疮合并丙型肝炎病毒感染的临床研究

Hepatitis C virus infection combined with systemic lupus erythematosus

目的:研究系统性红斑狼疮(systemiclupuserythematosus,SLE)患者中丙型肝炎病毒(hepati-tisCvirus,HCV)感染及其对SLE患者临床表现和免疫学检测指标的影响。方法:收集92例SLE患者和58例正常对照者血清,检测HCV及免疫学指标如抗核抗体(antinuclearantibody,ANA)等。根据结果将SLE患者分为HCV感染组和非感染组,并将HCV感染情况与临床表现和免疫学检测指标进行分析。结果:92例SLE患者中,13例(14.1%)存在HCV感染,58例正常人中有2例(3.4%)存在HCV感染。感染组口腔溃疡、关节炎、浆膜炎、肾病、神经精神症状、发热阳性率和实验室检查中ANA,Anti-Ro/SSA,Anti-La/SSB,抗Smith抗体(Anti-Sm),IgG和IgM阳性率与非感染组比较,差异无统计学意义(P>0.05)。而感染组蝶形红斑阳性率、抗dsDNA阳性率低于非感染组(P<0.05);皮肤血管炎、肝损害、类风湿因子阳性率、低C3及低C4阳性率则多于非感染组(P<0.05)。结论:SLE患者感染HCV比例明显升高,HCV感染可以影响SLE患者的某些临床表现和免疫学指标。

Objective To examine the hepatitis C virus （HCV） infection in systemic lupus erythematosus （ SLE ） patients, to investigate the influence of HCV infection, and to analyze the clinical appearances and experimental immunological characters of SLE. Methods Serum of 92 SLE patients and 58 normal control people was taken, and the HCV infection and experimental immunological characters were detected. SLE patients were divided into HCV infection group and non-HCV infection group according to the detective results. The immunological characters and clinical appearances were analyzed in the two groups. Results Thirteen of the 92 SLE patients were HCV positive, while only 2 of the 58 normal controls were positive. There were no significant differences in the clinical features including oral ulcer, arthritis, serositis, nephropathy, neural disorder, fever, as well as in the laboratory results including ANA, Anti-Ro/SSA, Anti-La/SSB, Anti-Sin, IgG and IgM in the two groups. HCV positive patients showed a lower frequency of butterfly erythema and positivity for anti-dsDNA, and a higher frequency of cutaneous vasculitis, liver damage, positivity for RF and low C3, C4 levels. Conclusion Patients with SLE showed a high prevalence of HCV infection, and HCV may cause some clinical and immunological changes in SLE.