伴雷诺现象的系统性红斑狼疮43例分析

Clinical analysis of 43 cases of systemic lupus erythematosus with Raynaudˊs phenomenon

目的：探讨伴雷诺现象（ RP）的系统性红斑狼疮（ SLE）患者的临床特征。方法：对2011～2013年在我院住院的伴RP的43例SLE患者临床表现进行回顾性分析，并与96例无RP的SLE患者在临床表现、实验室检查等方面进行比较。结果：与无RP组相比．有RP组出现肌痛／肌炎、皮疹、关节痛（炎）、心脏受累和肺动脉高压的几率明显增高（分别为10．42％～25．58％、59．38％～81．40％、10．42％～46．51％、32．29％～51．16％、4．17％～27．91％。 P＜0．05）抗核抗体、抗RNP、抗Sm及γ－球蛋白升高的阳性率也明显增高（分别为62．50％～81．39％、23．96％～60．46％、11．46％～20．93％、47．92％～60．46％。 P＜0．05）、而2组患者肾脏受累、神经系统受累及血液系统受累的发生率差异无显著性（ P均＞0．05）。结论：SLE患者出现雷诺现象提示较易发生肾脏受累、肺动脉高压、心脏受累和免疫学异常，对伴雷诺现象的SLE患者应注意早发现、以便早期诊断和治疗，以防不良后果发生。

Objective：To explore the clinical manifestationsof the patients with systemic lupus erythematosus（SLE） with Raynaudˊs phenomenon.Methods：We retrospectively analyzed the clinical manifestations of 43 SLE patients with Raynaudˊs phenomenon and com-pared with those of 96 SLE patients without Raynaudˊs phenomenon in system injury and laboratory examination.Results： As compared with SLE patients with Raynaudˊs phenomenon, the SLE patients with Raynaudˊs phenomenon were more likely to have myalgia/myopathy、erythra、arthralgia、cardiac involvement、pulonary hypertension（10.42%vs25.58%、59.38%vs81.40%、10.42%vs46.51%、32.29%vs51.16%、4.17%vs27.91%. P〈0.05） positive antinuclear antibodics、positive anti-dsDNA antibodies、positive anti-RNP antibod-ies、positive anti-Sm antibodies、 elevated serum level of gamma-globumin （62.50%vs81.39%、23.96%vs60.46% 、11.46%vs20. 93%、47.92%vs60.46%. P〈0.05） There were no significant differences in nephritis、neuropsychiatric and hematologic alterations be-tween two groups.Conclusion：The Raynaudˊs phenomenon in SLE patients seems susceptible to nephritis alteration、pulmonary hyperten-sion、Cardiac involvement and immunologic abnormalities.We should pay special attention to the function of heart and lung and pulmonary hypertension , in order to avoid unfavorable consequences.