系统性红斑狼疮并发骨坏死22例临床分析

Clinical analysis of systemic lupus erythematosus complicated with osteonecrosis in 22 patients

目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)并发骨坏死的临床特点。方法回顾性分析22例SLE合并骨坏死患者的临床资料。结果 SLE合并骨坏死占同期SLE住院患者的8.8%,发病年龄为(36±13)岁;患者均有皮肤黏膜损害,关节肌肉疼痛20例、肾脏损害16例、血液系统损害10例、双手雷诺现象12例;免疫学检查见IgG升高16例、抗uRNP/Sm阳性16例;22例发生股骨头近端坏死,其中8例为双髋受累,4例单髋受累,8例股骨远端伴胫骨近端坏死,2例为距骨坏死;MRI检出率为100%。结论 SLE并发骨坏死发病早、临床表现多样,MRI检查可早期诊断骨坏死。

Objective To explore the clinical characteristics of systemic lupus erythematosus （SLE） complicated with osteonecrosis. Methods The clinical data o{ 22 SLE patients complicated with osteonecrosis were retrospectively analyzed. Results The SLE patients with osteonecrosis accounted for 8.8 % in all SLE patients, and the age of onset was （36± 13） years old. In 22 patients, skin lesions were found in all patients, joint and muscle pain in 22, kidney damage in 16, blood system damage in 10, and two-hand Raynand＇s phenomenon in 12. Immunological tests showed elevated IgG in 16 patients and positive anti-uRNP/Sm in 16. Proximal femoral head necrosis occurred in 22 patients including 8 patients with two-hip involvement and 4 patients with one-hip involvement, distal femur and proximal tibia necrosis in 8, and talus necrosis in 2. The detection rate of MRI was 100%. Conclusion Osteoneerosis develops early with various clinical manifestations in SLE patients, and it can be detected in its early stage by MRI.