以肠系膜血管炎为首发表现系统性红斑狼疮的诊断

Diagnosis of mesenteric vasculitis as initial manifestation of SLE

目的探讨以肠系膜血管炎为首发表现系统性红斑狼疮的诊断;方法回顾性分析15例因狼疮性肠系膜血管炎初诊为SLE患者的临床资料;结果(1)所有患者临床症状以腹痛、恶心/呕吐及腹泻为主;(2)大多数患者伴有血白细胞减少及血C3降低;(3)8例腹部增强CT均见肠管扩张,肠壁增厚,呈"靶形"改变;(4)所有患者均经大剂量糖皮质激素治疗后病情好转;结论(1)狼疮性肠系膜血管炎以非特异性胃肠道症状为主要表现;(2)狼疮性肠系膜血管炎是SLE病情的活动表现;(3)腹部增强CT有利于狼疮性肠系膜血管炎的早期诊断;(4)狼疮性肠系膜血管炎须大剂量糖皮质激素治疗。

Aim To explore the diagnosis of mesenteric vasculitis as initial manifestation of SLE. Methods 15 mesenteric vasculitis as initial manifestation of SLE were retrospectively analyzed. Results Abdominal pain, nausea, vomitting or diarrhea were the main manifestations of mesenterie vasculitis due to SLE. Most of the patients were accompanied with leucopenia and hypocomplementemia. The enhanced CT of the abdomen showed marked bowel wall thickening with target sign in 8 cases. All the patients recovered for the large dosage of corticostemids therapy. Conclusions The main manifestations were non-specific gastrointestinal symptoms in patients with mesenteric vasculitis due to SLE. Mesenteric vaseulitis occurred in the active stage of SLE. Enhanced CT scan of abdomen was useful in assessing the presence of mesenteric vasculitis due to SLE. Large dosage of corticostemids was necessary for mesenteric vasculitis therapy.