晚发系统性红斑狼疮102例临床分析

Clinical Analysis of 102 Cases Late-onset Systemic Lupus Erythematosus

目的探讨晚发系统性红斑狼疮(SLE)的临床特征。方法收集晚发SLE(发病年龄≥50岁)102例和同期早发SLE(发病年龄<50岁)415例患者资料,比较分析两组的临床表现、实验室指标。结果晚发SLE占所有SLE患者的19.7%。其中女∶男为5.38∶1,明显低于早发组(女∶男为11.2∶1),差异有统计学意义(P<0.01)。晚发组发病到确诊的平均时间长,疲乏、关节痛、体重下降、肌痛肌无力、肺部病变发生率高,肾损害、雷诺现象、脱发的发生率低(P<0.05),血沉增快、肝功能损害检出率高,而补体(C3C4)降低、白蛋白降低、dsD-NA阳性检出率低(P<0.05)。结论晚发SLE在临床表现及实验室检查等方面不典型,在临床诊治中应给予足够重视。

Objective To investigate the clinical characteristics of late-onset systemic lupus erythematosus （SLE） .Methods Clinical and laboratory information of 102 patients with late-onset SLE（ aged 50 and above） and415 patients with early-onset SLE（aged below 50 years）were collected and compared. Results The late- onset SLE patients accounted for19.7% of the homochronous admission SLE cases. The ratio of female to male in the late-onset SLE group was significantly lower than that in early-onset SLE group （ P 〈 0.01 ）. The average time from onset to diagnosis in the late-onset SLE group was longer than that in the early-onset group （ P 〈 0.05）. Fatigue, arthritis, weight losing, muscular pain, weakness of the muscle and pneumonopathy in the late- onset group were significantly higher than that in the early-onset group. Renal damage, Raynaud＇ s phenomenon and baldness were significantly rarer in the late-onset group than that in the early-onset group （ P 〈 0.05）. The increase of ESR and liver function damage were significantly higher than that in the early group. But low complements C3C4 and the positive rates of antibody of anti-ds-DNA in late-onset group were significantly less frequent （P 〈0.05） than that in early-onset group. Conclusion The late-onset SLE was atypical in clinical manifestation and immunology examination, so attention should be paid to these in clinical diagnosis and treatment.