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目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)并发骨坏死的临床特点。方法回顾性分析22例SLE合并骨坏死患者的临床资料。结果 SLE合并骨坏死占同期SLE住院患者的8.8%,发病年龄为(36±13)岁;患者均有皮肤黏膜损害,关节肌肉疼痛20例、肾脏损害16例、血液系统损害10例、双手雷诺现象12例;免疫学检查见IgG升高16例、抗uRNP/Sm阳性16例;22例发生股骨头近端坏死,其中8例为双髋受累,4例单髋受累,8例股骨远端伴胫骨近端坏死,2例为距骨坏死;MRI检出率为100%。结论 SLE并发骨坏死发病早、临床表现多样,MRI检查可早期诊断骨坏死。
Objective To investigate the clinical features of systemic lupus erythematosus (SLE) complicated with osteonecrosis. Methods The clinical data of 22 patients with SLE combined with osteonecrosis were retrospectively analyzed. Results SLE combined with osteonecrosis accounted for 8.8% of hospitalized patients with SLE in the same period. The age of onset was (36 ± 13) years old. All patients had mucocutaneous damage, 20 cases of joint and muscle pain, 16 cases of renal damage, 10 cases of hematological damage, There were 12 cases in immunosurgery. 16 cases were elevated IgG and anti-uRNP / Sm were positive in 16 cases. Necrosis of proximal femoral head occurred in 22 cases, including 8 cases of double hip involvement, 4 cases of single hip involvement, 8 cases of distal femur With the proximal tibia necrosis, two cases of talus necrosis; MRI detection rate was 100%. Conclusions The incidence of SLE complicated by osteonecrosis is early and the clinical manifestations are diverse. MRI can diagnose early stage of osteonecrosis.