儿童与成人系统性红斑狼疮的临床和免疫学特征比较

Comparison of Clinical and Immunologic Features between Children and Adult Patients with Systemic Lupus Erythematosus

目的探讨儿童与成人系统性红斑狼疮(systemic lupus erythematosus,SLE)的首发临床表现和免疫学特征的区别。方法回顾性分析2002年6月—2007年6月湘雅医院住院诊治的49例儿童SLE(儿童组)的首发症状和免疫学特征,并与同期收治的50例成人SLE(成人组)进行比较。结果与成人组相比,儿童组SLE发病至确诊的时间更长,疾病活动度更高,消化系统受累和淋巴结增大等表现更多见,抗双链DNA抗体(AdsDNA)和抗核糖体P蛋白抗体(ARPA)的阳性率更高,差异均有统计学意义(P均<0.05)。结论与成人SLE相比,儿童SLE更容易误诊,而且疾病活动度更高。提示正确认识儿童SLE的临床和免疫学特点,及早诊治对改善预后有重要意义。

Objective To explore the differences of first clinical and immunologic features between children and adult patients with SLE.Methods A retrospective analysis was conducted on clinical data of 99 patients with SLE（50 adults,49 children） collected during June 2002 and June 2007.The differences of the first clinical and immunologic features between children with SLE（children group） and adult patients with SLE（adult group） were compared.Results Pediatric SLE was more prone to be misdiagnosed and had a higher disease activity,when compared with that of adults with SLE;digestive system symptoms,lymphadenectasis,positive anti-dsDNA antibody（AdsDNA） and anti-ribosomes P-protein antibody（ARPA） were found with significant difference in pediatric SLE（P0.05）.Conclusion Pediatric SLE is prone to be misdiagnosed when compared with that of adults with SLE and disease activity is higher than that of adults with SLE.Clinicians should improve awareness of the clinical and immunological characteristics of child patients with systemic lupus erythematosus,which is significant in early diagnosis,treatment and prognosis.