系统性红斑狼疮并发眼底损害的临床分析

Clinical analysis of systemic lupus erythematosus complicated fundus damage

目的:分析系统性红斑狼疮(systemic lupus erythematosus,SIE)并发眼底损害3例患者病例资料并复习文献,总结SIE并发眼底损害的临床特点,提高诊治意识,改善预后。方法:对3例3只眼SLE并发眼底损害的患者进行眼底检查,分析血免疫球蛋白(GIB)、抗核抗体(ANA)、抗双链DNA(抗dsDNA)抗体、补体3(C3)、抗心磷脂抗体(ACA)、抗中性粒细胞胞浆抗体(ANCA)和C反应蛋白(CRP),计算SLEDAI评分,复习文献并总结其临床特征。结果:3例患者眼底损害均在SLE治疗过程中出现,临床表现轻重不等,但病情进展快,从视物模糊到失明仅需数天;眼底损害与SLE疾病活动性、系统炎症反应强度、自身抗体类别及其滴度无关。结论:SLE并发眼底损害缺乏特异的临床与辅助检查指标,预后极差,早诊断早治疗是改变预后的唯一关键。

Objective： Analysis of systemic lupus erythematosus in 3 cases patients with fundus damage and literature review, to summarize the clinical characteristics and to improve the diagnosis and treatment consciousness. Methods： On 3 eyes of 3 cases of SLE complicated with fundus damage patients with fimdus examination, to analysis GLB, ANA. anti dsDNA. C3. ACA. ANCA and CRP, SLEDAI score, reviewed the literature and summarize its clinical characteristics. Result： fimdus damage has no relationship with SLE disease activities, systemic inflammation level,, autoantibody class and its titer. Conclusion： SLE patients combined with fundus damage don＇t have clinical and auxiliary examination index, and have poor prognosis, early diagnosis and treatment is the only key to change the prognosis.