系统性红斑狼疮继发肠系膜血管炎患病率及临床分析

Prevalence and Clinical Analysis of Mesenteric Vasculitis Secondary to Systemic Lupus Erythematosus

目的探讨系统性红斑狼疮(SLE)并发肠系膜血管炎(LMV)的临床特点,提高对此类患者的诊治水平。方法对2012年1月至2019年8月住院SLE并发LMV患者的临床资料、辅检、诊治情况进行回顾性分析。结果①此期住院SLE患者523例,并发LMV8例(患病率为1.53%)。②SLE并发LMV时,患者均有腹痛,3例腹泻,7例有恶心呕吐。1例有假性肠梗阻,1例肾积水。③4例LMV有血液系统受累,3例24 h尿蛋白≥0.5 g,8例LMV补体均下降,自身抗体表现各异。8例患者SLEDAI-2000为(7±4)分。8例患者腹部CT可见肠壁不同程度的水肿和增厚。④给予LMV患者大剂量激素治疗后,病情均得到缓解。结论LMV以腹痛为主要表现,可伴腹泻,恶心呕吐等症状。腹部CT检查有助LMV的早期诊断。及时大剂量糖皮质激素治疗,可改善LMV患者预后。

Objective To investigate the clinical features of systemic lupus erythematosus(SLE) complicated with lupus mesenteric vasculitis(LMV),and to improve the diagnosis and treatment of these patients. Methods The clinical data, laboratory parameters, auxiliary examination and treatment of SLE patients complicated with LMV from January 2012 to August 2019 were retrospectively analyzed. Results(1) there were 523 SLE patients and LMV 8 cases(prevalence was 1.53%) in this period.(2) When SLE complicated with LMV, all patients had abdominal pain, 3 had diarrhea, 7 had nausea and vomiting. One case had pseudo intestinal obstruction and one case had hydronephrosis.(3) 4 cases of LMV had blood system involvement,3 cases had 24-hour urine protein≥0.5 g, 8 cases of LMV complement decreased, the performance of autoantibodies was different. SLEDAI-2000score of 8 patients was(7±4). Abdominal CT of 8 patients showed edema and thickening of intestinal wall.(4) Patients with LMV were treated with high-dose glucocorticoids, and their symptoms were all relieved. Conclusion Abdominal pain is the main manifestation of LMV, accompanied by diarrhea, nausea and vomiting. Abdominal CT is helpful for the early diagnosis of LMV. Timely treatment can improve the prognosis of LMV.