系统性红斑狼疮并弥漫性肺泡出血17例临床分析

Clinical Analysis of 17 Patients with Systemic Lupus Erythematousus Complicated with Diffuse Alveolar Hemorrhage

目的:总结系统性红斑狼疮(SLE)并弥漫性肺泡出血(DAH)的临床特点。方法:回顾性分析2002年1月-2012年1月我院SLE并DAH患者17例的临床资料。结果:SLE并DAH的发病率为1.3%(17/2235;女性16例,SLEDAI评分平均(14.1±3.2)分;常见症状为发热、呼吸困难、咳血;患者接受积极抗感染、大剂量激素、免疫抑制剂及丙种球蛋白治疗,死亡率为59%(10/17)。结论:DAH是SLE的少见并发症,好发女性,多发生于SLE活动期,常合并严重肺部感染,死亡率高。

Objective： To summarize the clinical features of systemic lupus erythematousus （SLE） complicated with diffuse alveolar hemorrhage （DAH）. Methods：The clinical data of 17 patients with SLE complicated with DAH were analyzed retrospectively from Jan 2002 to Jan 2012. Results： The incidence of DAH involvement of SLE was about 1.3% （17/2235）, 16 cases were female. The SLEDAI score was （14.1±3.2） points. The main clinical manifestations of DAH were fever, dyspnea, hemoptysis. Although the cases were received active antibiotic treatment and steroid, immunosuppressant and immunoglobulin pulse therapy, the mortality was 59%. Conclusion： DAH is a rare involvement of SLE, most of the cases are female and associated with active disease. Severe secondary pulmonary infections were usual and the mortality rate is high.