56例儿童系统性红斑狼疮的临床分析

Clinical analysis of 56 cases of hospitalized children with systemic lupus erythematosus

目的了解我院住院儿童系统性红斑狼疮的临床及用药情况,为科学诊治提供依据。方法应用描述性方法对我院2013年03月至2019年03月共56例住院患儿系统性红斑狼疮进行回顾性分析。结果 56例患儿中,最小发病年龄为7岁;男女比例约为1∶3.3;多以发热、蝶形红斑、肾脏损害、关节疼痛起病;临床主要表现有面部蝶形红斑、肾脏损害及关节疼痛;有33例有血液学改变(贫血、血小板减少),占58.93%;自身抗体阳性率高,以抗核抗体(ANA)(89.29%)、抗dsDNA抗体(76.79%)常见;有42例行肾脏病理学检查(42.86%),以II型及IV型多见;56例患儿均使用激素治疗,43例使用免疫抑制剂,以单用环磷酰胺及吗替麦考酚酯多见,分别占30.36%及23.21%。结论儿童系统性红斑狼疮可累及多系统,早期临床症状不典型,容易误诊,且具有病程长、容易反复的特点。

Objective To investigate the clinical characteristics and therapy of systemic lupus erythematosus(SLE)in children in our hospital,to provide the basis for scientific diagnosis and treatment.Methods A descriptive clinical epidemiological methods was applied on retrospectively study of a total of 56 cases hospitalized children with SLE in our hospital from March 2013 to March 2019.Results In the 56 cases of children with SLE,the minimum age was 7;The proportion of male and female was 1∶3.3;The disease often began with fever、butterfly erythema、renal damage、arthritis;The clinical symptoms commonly occurred in forms of butterfly erythema、renal damage、arthritis;Blood system changed in 33 cases in form of anemia and thrombocytopenia,accounted for 58.93%;The positive rate of auto-antibody such as ANA(89.29%)、ds-DNA(76.79%)was higher;II and IV were the most common type in renal biopsy in 42 cases;Glucocorticoids terapy was given in all 56 cases;Immunosuppressor therapy wsa given in 43 cases;Cyclophosphamide alone(30.36%)and Mycophenolate Mofetil alone(23.21%)were commonly used.Conclusion SLE can refers to many systems,and the early clinical symptoms are not representative,which can lead to misdiagnose.SLE has the characteristics of long course and easily repeat.