口腔盘状红斑狼疮临床表现及血清免疫学分析

Analysis of the Clinical Manifestations and Seroimmunology of Oral Discoid Lupus Erythematosus Patients

目的分析口腔盘状红斑狼疮口腔及全身临床表现特点;分析口腔盘状红斑狼疮患者血清抗核抗体、IgG、IgA、IgM特点。方法病例来源于上海交通大学医学院附属第九人民医院口腔黏膜科,1978年至2009年间符合临床及病理诊断为＂口腔盘状红斑狼疮＂的病例共174例。使用Microsoft Office Access2007程序回顾分析这些资料;并通过SAS6.12版本软件进行t检验及Logistic回归分析。结果 174例中,44.5%病损位于下唇,55.2%病损表现为糜烂。16.7%患者存在皮肤损害、关节炎、精神症状等全身表现。174例中,血清抗核抗体阳性占17.2%,IgG升高占45.9%,IgA升高占10.3%,IgM升高占2.3%。活动期患者血清IgG显著升高（P〈0.05）。结论口腔盘状红斑狼疮好发于下唇,病损多表现为糜烂,少数患者伴有全身损害;部分口腔红斑狼疮患者血清免疫球蛋白升高,抗核抗体阳性,疾病活动性与血清IgG升高有关。

Objective To describe the oral and systemic clinical manifestations of oral discoid lupus erythematosus（DLE）.To analyze the distribution of IgG、IgA、IgM and anti-nuclear antibody（ANA） in oral DLE.Methods A total of 174 charts of patients with histologically and clinically confirmed oral DLE were collected from department of oral mucosa in Ninth People＇s Hospital of Shanghai Jiaotong University between 1978 and 2009.Statistical analyses were done using the Microsoft Office Access2007 and SAS 6.12 software package.Results Of the 174 patients,44.5% of the lesions in the lower lip,55.2% showed erosive lesions.16.7% of the oral DLE patients had additional features such as arthralgia,skin lesions and so on.Serum ANA positive accounted for 17.2%,IgG increased share of 45.9%,IgA increased share of 10.3%,IgM increased share of 2.3%.IgG was statistically different between active patients and inactive patients（P0.05）.Conclusion Lower lip was the most predilection site.Erosive lesions showed more.Part of the oral DLE patients had systemic manifestation.The disease activity of oral DLE had relation to the serologic IgG.