13例狼疮危象临床分析

Clinical analysis of 13 patients with crisis of systemic lupus erythematosus

目的探讨狼疮危象的临床特点及防治措施。方法回顾性分析本院2002年1月至2007年1月收治的131例次系统性红斑狼疮患者的资料。结果发生狼疮危象13例,发生率为9.92%,其中男1例,女12例,年龄19～48岁,平均33岁;从发病至狼疮危象发生的时间为3～118个月,平均44个月;有明确诱因12例：包括不规则使用或未使用激素8例,肺部感染2例,情绪激动1例,过度劳累1例,另有1例原因不明;经给予小剂量甲基强的松龙（80～480 mg/d,3～5 d）冲击治疗,部分患者给予环磷酰胺冲击或加用丙种球蛋白治疗,所有患者均病情好转出院。结论狼疮危象的发生多与不正规使用激素及免疫抑制剂有关,早期正规使用激素及免疫抑制剂控制狼疮活动,可减少狼疮危象的发生。而一旦发生狼疮危象,则及早使用甲基强的松龙及环磷酰胺冲击治疗,必要时加用丙种球蛋白治疗,可明显提高抢救成功率,改善患者预后。

Objective To investigate the clinical characteristics and measures of prevention and treatment for the crisis of systemic lupus erythematosus（SLE）.Methods An restrospective analysis was proceeded for 131 SLE patients in our hospital from Jan.2002 to Jan.2007.Results Among 131 SLE patients,13 patients developed crisis of SLE.The rate of occurring was 9.92%;one male and twelve female.The age was from 19 to 48 years old,the average age was 33;from disease occurring to develop the crisis,the time was 3-118 months,average was 44 months.12 cases have clear induse cause：including irregular using hormone 8 cases;lung infection 2 cases,exciting emotion 1 case,too tired 1 case;unknown cause 1 case.The impacting treatment was given low-dose pulse methylprednisolone for every patient,and CTX and gamma globulins for some patients.All patients became better and discharged.Conclusion The crisis of SLE is related to irregular using hormone.It can decrease the occurring of crisis of SLE using hormone and immune inhibitor earlier.Once the crisis occurred,the impacting treatment of using pulse methylprednisolone,CTX and gamma globulins should be given as soon as possible.It can increase the success rate of emergency treatment and improve the prognosis of treatment.