系统性红斑狼疮合并抗磷脂综合征患者的临床分析

Clinical characteristics of 39 patients with systemic lupus erythematosus and antiphospholipid syndrome

目的 研究系统性红斑狼疮合并抗磷脂综合征（SLE-APS）患者的临床特点.方法 对39例SLE-APS患者的临床和实验室资料进行回顾性分析.结果 39例患者中,有31例共发生了48次血栓栓塞事件,以深静脉血栓及脑梗死为主.26例已婚有生育史女性患者中,有12例发生病态妊娠.28例抗心磷脂抗体阳性 16例狼疮抗凝物阳性.24例患者先确诊SLE,平均9.5年后又出现APS样表现 12例先出现反复病态妊娠或血栓事件,平均4.8年后演变为SLE 3例一发病便同时符合SLE和APS的分类标准.有5例在发生血栓事件或病态妊娠时的狼疮活动指数〈5分.结论 SLE-APS患者血栓事件及病态妊娠发生率增多.APS可出现于SLE之前、之后或同时.狼疮患者可以在病情稳定期出现APS的表现.详细询问病史、常规检测抗心磷脂抗体,有助于发现SLE-APS的高危因素,积极预防APS的发生.

Objective To understand the clinical characteristics of systemic lupus erythematosus with Antiphospholipid syndrome （SLE-APS）.Methods The clinical data of 39 cases of SLE-APS were collected and analyzed retrospectively. Results Thirty-one patients had 48 thrombosis episodes in total, among which the most common presenting manifestations were deep venous thrombosis and stroke. 12 of 26 married women had fetal morbidity. The prevalence of anticardio lipin antibody （aCL） and lupus anticoagulant （ LA） was 72% and 41% , respectively. 24 patients had SLE at first,on an average of 9. 5 years later they had the characteristics of APS, 12 patients had thrombosis episodes or fetal morbidities ,4. 8 years later they developed into SLE,and 3 patients had the characteristics of SLE and APS from the onset The SLEDAI was less than 5 in five cases when they had thrombosis episodes or fetal morbidities.Conclusions The incidence of thrombosis episodes or fetal morbidities increased in SLE-APS patients. APS occurred before, after or at the same time with SLE. SLE patients might have the clinical features of APS during the steady stage. It＇s very important to ask the medical history in detail and measure aCL in lupus patients to find the risk factor of APS and prevent the APS＇ occurrence.