目的:分析系统性红斑狼疮(SLE)的临床特征、治疗及预后,提高医生对SLE合并脏器损伤导致猝死的认识。方法:回顾性分析1例确诊为SLE合并肺部感染猝死的临床特征及治疗过程并结合文献进行复习。以"系统性红斑狼疮猝死"及"Su...目的:分析系统性红斑狼疮(SLE)的临床特征、治疗及预后,提高医生对SLE合并脏器损伤导致猝死的认识。方法:回顾性分析1例确诊为SLE合并肺部感染猝死的临床特征及治疗过程并结合文献进行复习。以"系统性红斑狼疮猝死"及"Sudden death of systemic lupus erythematosus"为关键词检索1984年1月至2017年2月万方数据库、中国知网及PubMed数据库的相关文献,共获得文献9篇,其中中文2篇,英文7篇。结果:患者女性,26岁,主要临床表现为面部蝶形红斑、发热、胸闷。肾穿刺活检:局灶增生性狼疮性肾炎基底膜增厚,胸部CT示双肺炎症,治疗过程中突然出现室颤而导致死亡。经文献检索共检索到11例SLE猝死患者,5例女性,3例男性,3例性别不详,其中4例资料不全,年龄22~64岁。结论:SLE常合并多系统损伤,当出现心血管症状时,由于常合并其他脏器受累容易被忽视,所以应及时进行心电图、心肌酶、肌钙蛋白等检查,并加强对患者的监护,防止猝死的发生。展开更多
Pseudomonas aeruginosa（PA） pneumonia is a refractory, even lethal complication in immunosuppressive individuals and immune disturbances may promote the pathological process. We aimed to investigate the regulatory T...Pseudomonas aeruginosa（PA） pneumonia is a refractory, even lethal complication in immunosuppressive individuals and immune disturbances may promote the pathological process. We aimed to investigate the regulatory T（Treg） cell activity in an immunosuppressive mice model of PA pneumonia by estimating levels of main transcription factor and the main effector of Treg cells, i.e., Forkhead box protein 3（FOXP3） and interleukine-10（IL-10）. Seventy-two BALB/c mice were divided into four groups randomly： control（A）, PA pneumonia（B）, immunosuppression（C） and immunosuppression with PA pneumonia（D）. Mice were sacrificed at 4, 8 and 24 h after establishing experimental models. The pathological changes of lung tissue were graded, and the FOXP3 m RNA and serum IL-10 levels were detected. Histological analysis of lung tissues showed there were no significantly pathological changes in groups A and C, but significantly pathological changes were found in groups B and D, especially in group D at 8 h（P〈0.05）. The expression levels of FOXP3 m RNA in groups A and C showed no significant changes at the three time points, which were significantly lower than those in groups B and D（P〈0.05）. FOXP3 m RNA levels were lowest at 4 h, and there was significant difference between groups B and D（P〈0.05）. The serum levels of IL-10 in groups A and C were almost normal at the three time points, but decreased significantly in groups B and D（P〈0.05）. The serum levels of IL-10 decreased to the lowest at 8 h, especially in group D（P〈0.05）. The results indicate that PA pneumonia in immunosuppressive individuals worsens rapidly, which may be associated with Treg cells function disturbance. And Treg cells may be promising as adjuvant therapeutics for PA pneumonia in immunosuppressive individuals.展开更多
文摘目的:分析系统性红斑狼疮(SLE)的临床特征、治疗及预后,提高医生对SLE合并脏器损伤导致猝死的认识。方法:回顾性分析1例确诊为SLE合并肺部感染猝死的临床特征及治疗过程并结合文献进行复习。以"系统性红斑狼疮猝死"及"Sudden death of systemic lupus erythematosus"为关键词检索1984年1月至2017年2月万方数据库、中国知网及PubMed数据库的相关文献,共获得文献9篇,其中中文2篇,英文7篇。结果:患者女性,26岁,主要临床表现为面部蝶形红斑、发热、胸闷。肾穿刺活检:局灶增生性狼疮性肾炎基底膜增厚,胸部CT示双肺炎症,治疗过程中突然出现室颤而导致死亡。经文献检索共检索到11例SLE猝死患者,5例女性,3例男性,3例性别不详,其中4例资料不全,年龄22~64岁。结论:SLE常合并多系统损伤,当出现心血管症状时,由于常合并其他脏器受累容易被忽视,所以应及时进行心电图、心肌酶、肌钙蛋白等检查,并加强对患者的监护,防止猝死的发生。
基金supported by grants from Science and Technology Department of Henan Province,China(No.142300410327)Medical Science and Technology Program of Henan Province,China(No.201403060)
文摘Pseudomonas aeruginosa（PA） pneumonia is a refractory, even lethal complication in immunosuppressive individuals and immune disturbances may promote the pathological process. We aimed to investigate the regulatory T（Treg） cell activity in an immunosuppressive mice model of PA pneumonia by estimating levels of main transcription factor and the main effector of Treg cells, i.e., Forkhead box protein 3（FOXP3） and interleukine-10（IL-10）. Seventy-two BALB/c mice were divided into four groups randomly： control（A）, PA pneumonia（B）, immunosuppression（C） and immunosuppression with PA pneumonia（D）. Mice were sacrificed at 4, 8 and 24 h after establishing experimental models. The pathological changes of lung tissue were graded, and the FOXP3 m RNA and serum IL-10 levels were detected. Histological analysis of lung tissues showed there were no significantly pathological changes in groups A and C, but significantly pathological changes were found in groups B and D, especially in group D at 8 h（P〈0.05）. The expression levels of FOXP3 m RNA in groups A and C showed no significant changes at the three time points, which were significantly lower than those in groups B and D（P〈0.05）. FOXP3 m RNA levels were lowest at 4 h, and there was significant difference between groups B and D（P〈0.05）. The serum levels of IL-10 in groups A and C were almost normal at the three time points, but decreased significantly in groups B and D（P〈0.05）. The serum levels of IL-10 decreased to the lowest at 8 h, especially in group D（P〈0.05）. The results indicate that PA pneumonia in immunosuppressive individuals worsens rapidly, which may be associated with Treg cells function disturbance. And Treg cells may be promising as adjuvant therapeutics for PA pneumonia in immunosuppressive individuals.
