以血液系病变为首诊的系统性红斑狼疮20例临床分析

Clinical Analysis of SLE with Haematological Presentations as the First Symptom

目的 :探讨系统性红斑狼疮 (SLE)的血液系统改变。方法 :2 0例以血液系统病变为首诊的SLE患者 ,分析其临床表现、体征及外周血象、骨髓象改变。结果 :2 0例患者中贫血 1 6例 ,白细胞减少 1 0例 ,血小板减少 1 2例。骨髓细胞学检查示 :缺铁性贫血 (IDA) 2例 ,再生障碍性贫血 (AA) 1例 ,溶血性贫血 (HA) 3例 ,环形铁粒幼细胞性贫血 1例 ,原发性血小板减少性紫癜 (ITP) 2例 ,余骨髓象为非特异性改变。结论 :以血液系统改变为首发或突出症状的SLE患者 ,早期临床症状不典型 ,故对于年轻女性 ,若伴有骨髓象示ITP、AIHA或血细胞减少而骨髓细胞形态无异常 ,应进行免疫学筛选及随访 。

Objective: To study the haematological lesions of 20 SLE.Methods:The clinical symptoms,signs,change of blood and bone medullary in 20 SLE patients with haematological as the first presentations were analyzed.Results:Of the 20 patients,16 were anemia,10 were leukopenia and 12 were thrombocytopenia.For bone medullary,2 cases were iron deficiency anemia,1 was aplastic anemia,3 were hemolytic anemia,1 was round ideroblastic anemia and 2 were idiopathic thrombocytopenia purpura,the others were no special change.Conclusion:The SLE patients with haematological presentations as the first symptoms have no typical clinical SLE manifestation in early days.To some people especially young female with idiopathic thrombocytopenia purpura,autoimmune hemolytic anemia and hypocytosis whose cell’s morphology in bone medullary is normal,we should screen them with immunological method and subsequent observation to examine any possibility of SLE.