系统性红斑狼疮并发胃肠道症状的临床分析

Clinical analysis of gastrointestinal manifestations in systemic lupus erythematous

目的:了解系统性红斑狼疮(SLE)并发胃肠道症状的临床特征,提高对该病的诊治水平。方法:选取收治的82例SLE患者。系统性地分析了SLE患者临床资料。结果:22例(26.8%)合并有胃肠道症状。6例(27.2%)以胃肠道症状为首发症状。表现为腹痛有13例(59.1%),恶心、呕吐有12例(54.5%),腹泻有8例(36.4%),消化道出血有2例(9.1%)。合并胃肠道症状的患者出现肾盂输尿管扩张及雷诺氏现象的概率高于无胃肠道症状患者,差异有统计学意义(P<0.05)。低白蛋白血症、C3降低、C50降低以及ANCA阳性与合并胃肠道症状相关,差异有统计学意义(P<0.05)。多因素logistic回归显示,低C3、低C50、ANCA阳性以及雷诺氏现象为SLE合并胃肠道症状的独立预测因素。结论:胃肠道症状是SLE常见的可逆的并发症,在部分患者中可以表现为首发或主要的症状。雷诺氏现象、低补体血症及ANCA阳性会增加SLE并发胃肠道症状的风险。

Objective To analyze the clinical features of gastrointestinal manifestations in systemic lupus erythematous ( SLE)patients. Method We consecutively collected 82 cases of SLE patients. Clinical data of SLE patients were systematically reviewed.Results A total of 22 patients ( 26. 8% ) had SLE - related gastrointestinal manifestations. Gastrointestinal manifestationsoccurred as the initial symptoms in 6 patients (27. 2%). Thirteen patients (59. 1% ) had abdominal pain, 12 patients ( 54. 5%)had nausea and vomiting, 8 patients (36.4% ) had diarrhea, and gastrointestinal hemorrhage occurred in 2 patients (9. 1 % ). Raynaud^ phenomenon and pyeloureterectasis occurred more frequently in patients with gastrointestinal manifestations than thosewithout,the difference was statistically significant (P <0. 05). Hypoalbuminemia,decreased C3 ,CH50 ,and positive anti - neutrophilcytoplasmic antibody (ANCA) were significantly associated with gastrointestinal manifestations in SLE patients,the difference wasstatistically significant (P < 0 . 05). Multivariable logistic analysis showed that decreased C3, CH50, positive ANCA and Raynaud^phenomenon were independent predictors of gastrointestinal manifestations. Conclusion Gastrointestinal complications are common,and could be the initial or major manifestations of SLE. SLE patients with hypocomplementemia,positive ANCA and Raynaud^ phenomenonare at increasing risk of developing gastrointestinal complication.