摘要
目的分析老年系统性红斑狼疮(sty)的临床特点,提高对老年SLE的认识。方法回顾性分析本院风湿免疫科70例SLE患者的病例资料,按发病年龄分为2组,发病年龄≥50岁者(35例)为老年SLE组,发病年龄〈50岁者(35例)为中青年SLE组,分析比较2组患者的临床表现、实验室指标、治疗及合的差异。结果老年SLE组与中青年SLE组男女比为1:11比1:3,平均病程[3年比1年],发病至确诊的平均时间[0.5年比0.7年],差异均有统计学意义(P〈0.05)。老年SLE组狼疮性脱发发生率较低[0.0%(0/35)比28.6%(10/35),P〈0.05];血小板减少、肺间质病变发生率、C反应蛋白升高及肌酸激酶升高发生率均明显高于中青年SLE组[51.4%(18/35)比25.7%(11/35),34.3%(12/35)比8.6%(3/35),11.4%(4/35)比34.3%(12/35),80.O%(28/35)比57.1%(20/35),14.3%(5/35)比0.0%(o/35),P〈0.05];老年SLE组血肌酐升高,Sm抗体、抗dsDNA、抗Clq抗体阳性率低于中青年SLE组[11.4%(4/35)比34.3%(12/35),5.7%(2/35)比22.9%(8/35),14.3%(5/35)比54.3%(19/35),25.7%(9/35)比54.3%(19/35)。P〈0.05];老年SLE组泼尼松平均使用量低于中青年SLE组[(22.42±19.60)mg/d比(39.93±18.56)mg/d,P〈0.01];老年组高血压、骨质疏松发生率明显高于中青年SLE组(P〈0.05)。结论老年SLE患者男性发病较中青年SLE多,特异性自身抗体阳性率较中青年组低,发病至确诊的时间较长;生血小板减少、肺间质病变、高血压、骨质疏松发生率明显高于等中青年SLE多,因此,对老年SLE应注意多系统的病变,反复多次行自身抗体检测以尽可能早期诊断,并注意并发症的防治。
Objective To analyze the clinical features of systemic lupus erythematosus(SLE) in elderly, and improve the cognition of SLE in elderly. Methods We retrospectively collected 70 cases of patients' clinical data who were diagnosed of SLE. They were divided into two groups: elderly SLE group(35 cases) and young SLE group (35 cases). The course of the disease, time of onset to confirmation, clinical manifestation, various laboratory parameter,treatment and complication were recorded and then analyzed. Results The incidence rates of trichomadesis were lower in elderly SLE group than those in young SLE group[0.0% (0 case) vs 28.6% ( 10 cases) ,P 〈 0.051. While the rate of thrombocytopenia and interstitial lung disease and C-reactive protein and Creatine Phosphate Kinase in elderly SLE group were all higher compared with the young SLE group[51.4% (18 cases) vs 25.7% (11 cases) ,34.3% (12cases) vs 8.6% (3 cases) ,80.0% (28 cases) vs 57.1% (20 cases), 14.3% (5 cases) vs 0.0% (0 case) ,P 〈 0.05 ]. The percentage of blood creatinine, the elder's antibody positive rate of antinuclear antibodies(ANA) ,Anti-Sm,Anti-dsDNA and Anti-Clq were lower than those of young SLE group[ 11.4% (4 cases) vs 34.3 % ( 12 cases) ,48.6 % ( 17 cases) vs 85.7 % ( 30 cases ), 5.7 % ( 2 cases) vs 22.9% ( 8 cases ), 14.3 % ( 5 cases) vs 54.3 % ( 19 cases),25.7% (9 cases) vs 54.3% ( 19 cases), P 〈 0.05 ], and elders'ANA titer decrease (Z = 3. 284, P = 0.001 ). The late onset SLE of the average prednisone was lower than that of those in young SLE group[ (22.42 ± 19.60) mg/d vs(39.93 ± 18.56) mg/d,P 〈 0.01 ] ; amalgamated hypertension and osteoporosis were higher than those in young SLE group (P 〈 0.05 ). Conclusions Late onset SLE is characterized by thrombocytopenia, Kidney dysfunction, Interstitial lung disease and the low positive of antoantibody, such as ANA.
出处
《中国医药》
2011年第11期1366-1368,共3页
China Medicine
基金
国家“十一·五”科技支撑计划课题项目(2008BA159802)
关键词
红斑狼疮
系统性
老年
自身抗体
治疗
Lupus erythematosus, systemic, elderly
Antoantibody