儿童SLE53例分析

Clinical analysis of 53 eases of pediatric systemic lupus erythematosus

目的探讨儿童SLE的临床及实验室特点。方法对53例儿童SLE的临床资料进行回顾性分析。结果儿童SLE患者存在明显性别差异，男女比例为1：9．6。年龄7～14岁，中位数为12岁。首发症状以皮疹最为常见，占41．51％；其次为发热占20．75％；关节痛占20．75％。系统损害中最常受累的是血液系统，占84．90％；肾脏占60．38％，神经系统也易受累，占18．87％。血液、肾、神经系统受累最常见的表现分别为贫血、蛋白尿、癫痫。实验室检查ANA阳性率最高，占90．57％，其次为抗dsDNA抗体，占67．92％。男女在发病年龄、入院评分、出院评分、糖皮质激素起始剂量、出院剂量、住院时间等方面差异均无统计学意义。结论儿童SLE临床表现多样，倾向于多系统受累。应提高警惕，早期诊断积极治疗。

Objective To analyze the clinicaland laboratory characteristics of systemic lupus erythematosus （SLE） in children. Methods Fifty-three inpatients, 5 boys and 48 girls with SLE, who aged from 7 to 14 years with a median age at 12 years, were enrolled into this study. A retrospective study was carried out to assess the clinical and laboratory features of these pediatric patients. Results The ratio of male to female patients was 1：9.6. Skin eruption was the most common initial manifestation （41.51% ）, followed by fever （20.75%） and arthralgia （20.75%）. Systemic involvement was common, and 84.90% of these patients had hematological abnormalities, 60.38% renal involvement, 18.87% nervous involvement. The most common manifestation of hematological, renal and nervous involvement was anemia, proteinuria and seizures, respectively. Among the immunologic parameters tested, anti-nuclear antibody showed the highest positivity rate of 90.57%, followed by anti-dsDNA with a positivity rate of 67.92%. There was no significant difference between the male and female patients in the age of onset, SLEDAI score at admission and discharge, duration of hospitalization or the dose of corticosteroid used initially and at the discharge. Conclusion The manifestations of pediatric SLE are various, and multisystem involvement is common in these patients. Early diagnosis and active treatment might benefit the prognosis of pediatric SLE.