系统性红斑狼疮合并膝关节坏死的临床观察

A clinical study on knee osteonecrosis in patients with systemic lupus erythematosus

目的探讨SLE并发膝关节坏死（ONK）患者的临床特点。方法回顾性总结分析本院SLE合并ONK患者的临床资料。结果本院2008--2013年收治SLE患者81例，其中11例合并ONK，所有合并ONK的患者均为女性，发病年龄19～57岁，平均（36±13）岁；病程4．5～31年，平均（13±6）年；局部临床表现中膝关节肿胀伴疼痛5例，仅有疼痛无肿胀的I例，无症状者5例，所有患者均伴有股骨头无菌坏死。实验室检查中甘油三酯升高者7例，同时伴有胆崮醇升高者3例；口服糖皮质激素总的累计量为（66824±27328）mg。结论SLE合并ONK并非罕见，且多数患者有肾脏受累和血脂升高，以及长期的糖皮质激素治疗。

Objective To investigate the clinical features of osteonecrosis of the knee （ONK） in patients with systemic lupus erythematosus （SLE）. Methods A retrospective chart review was conducted to identify patients of SLE with ONK. The clinical characteristics of these patients were analyzed. Results Between 2008 and 2013, eighty-one patients with SLE were analyzed in the 210th Hospital of People＇s Liberation Army. Eleven of these patients were diagnosed as ONK. All of these ONK patients were female. The age of onset ranged from 19-57 （36±13） years. The disease duration ranged from 4.5-31.0 （13±6） years. The local clinical symptom included knee swelling with pain in 5 cases, only pain with no swelling in 1 patient, no symptoms in 5 patients. All patients were with aseptic necrosis of the femoral head. For laboratory examination, 7 patients had elevated triglyceride lipids in blood. Three of 7 patients accompanied with cholesterol level increased. Total cumulative dosage of oral corticosteroids was （66 824±27 328） rag. Conclusion ONK in patients of SLE is common and the majority of them have impaired renal function and elevated blood lipids, as well as long-term glucocortico-steroid therapy.