老年系统性红斑狼疮32例临床分析

Clinical analysis of SLE in the elderly for 32 cases

目的:探讨老年系统性红斑狼疮(Systemic lupus erythematosus,SLE)患者的临床表现、治疗情况及预后。方法:总结32例老年SLE患者临床表现、实验室指标及疗效等特点,并与同期253例中青年患者进行比较。结果:与中青年组比较,老年组首发症状心累气促比例增高(P<0.01),蝶形红斑、光敏感比例降低(P<0.05)。随着病情发展,浆膜炎、神经系统病变、心脏病变及肺脏病变发生率增高(P<0.05),蝶形红斑、脱发及发热发生率降低(P<0.05)。实验室指标中,血脂升高发生率更常见(P<0.01),而抗ds-DNA抗体、白细胞总数降低及红细胞沉降率阳性率降低(P<0.05)。另外,老年组伴发高血压及骨质疏松症比例增高(P<0.01),较少使用间歇静脉环磷酰胺治疗(P<0.05)。结论:老年系统性红斑狼疮起病隐匿,病程长,易误诊,治疗时应密切监测药物副作用。

Objective：To investigate the clinical features,treatment and outcomes of systemic lupus erythematosus（SLE）in the elderly. Methods：The Clinical manifestation,laboratory data and treatment effects in the elderly with SLE,were reviewed and compared with those report from the young and middle-aged in the same period.Results：Compared with middle-youth-aged group,dyspnea of first symptoms was obviously more（P0.01）,butterfly-wings erythema and photo sensetativity of first symptoms were less（P0.05）.Development as the illness,serositis,heart damage,lung damage,and damage in nerval systemwere mor（eP0.05）,but butterfly-wings erythema,alopecia and fever were less（P0.05）.In laboratory features,hyperlipemia was more（P0.01）,and positive anti-ds-DNA,high erythrocyte sedimentation rate（ESR）and low white blood cell were les（sP0.05）.On the other hand,hypertension and osteoporosis of comorbidities were more（P0.01）,intermittent intravenous cyclophosphamide（CTX）was less commonly used（P0.05）.Conclusion：SLE in the elderly is characterized by long course of disease which is occult in onset,and it is easy to be misdiagnosed.The side effect shoud be monitored closely.