老年初发的系统性红斑狼疮60例临床分析

来源 :临床皮肤科杂志 | 被引量 : 0次 | 上传用户:xiaolan
下载到本地 , 更方便阅读
声明 : 本文档内容版权归属内容提供方 , 如果您对本文有版权争议 , 可与客服联系进行内容授权或下架
论文部分内容阅读
目的:探讨老年初发的系统性红斑狼疮(SLE)患者的临床特点.方法:回顾性分析云南省第一人民医院风湿免疫科2003年1月-2013年1月629例初诊为SLE住院患者的临床资料,根据发病年龄分为老年组(年龄≥60岁)及中青年组(年龄<60岁),分析不同年龄SLE患者临床表现、免疫学指标及疾病活动之间的关系.结果:629例SLE患者中,老年组60例,中青年组569例.老年组男性比例及病死率均较高,且并发症多,两组差异均有统计学意义(P均<0.05);而关节炎、发热、血红蛋白降低、红细胞沉降率升高及补体C4降低的发生率,抗核小体核蛋白(RNP)抗体及抗Sm抗体阳性的发生率,两组差异均无统计学意义(P均>0.05).SLE老年组患者肌痛、肌无力、浆膜炎、心脏损害、肺脏损害、WBC降低和血小板降低的发生率均高于中青年组;而蝶形红斑、脱发、肾脏损害、雷诺现象、光敏感及补体C3降低的发生率和抗双链(ds)-DNA抗体以及抗核小体(Anu-A)抗体的阳性率均低于中青年组,差异均有统计学意义(P均<0.05).结论:老年SLE患者与中青年相比,临床表现存在多种差异,具有轻型化及非典型化特点,但特异性较高的免疫指标阳性率较低,且病死率高,须对老年发病的SLE患者提高警惕,临床上应避免漏诊及误诊.“,”Objective:To elucidate the clinical features of systemic lupus erythematosus(SLE) initially diagnosed in the elderly.Methods:They retrospectively analyzed the clinical data of a total of 629 patients with SLE initially diagnosed and admitted to the Department of Rheumatology of their hospital from January 2003 to January 2013.Patients were divided into two groups,i.e.age ≥60(aged) and <60 years old(young/middle aged).The differences in clinical features,immunological indices and disease activity were compared between these two age groups.Results:The number of patients in aged and young/middle aged groups were 60 and 569 patients,respectively.The male to female ratio,mortality and complication rates were significantly higher in aged group than in young/middle aged groups(P<0.05),while there were no dramatic differences in the incidence of fever,arthritis,extent of decreased hemoglobin level and increased erythrocyte sedimentation rate,incidence of reduction in complement C4 levels,or the positivity rate of anti-ribonucleoprotein(RNP),and positive rates of anti-Sm autoantibodies between the two groups(P>0.05 for all).However,aged group displayed higher incidence of myalgia,myasthenia,serositis,heart and lung damages,decreased WBC and platelet counts(P<0.05,vs.young/middle aged groups).In contrast,young/middle group exhibited higher incidence of butterfly rash,alopecia,renal damage,Raynaud\'s phenomenon,photosensitivity,decreased complement C3 level,positivity rates of anti-dsDNA and anti-nucleosome antibodies(P<0.05,vs.aged group).Conclusions:In comparison with young/middle patients,the symptoms and signs of SLE in aged patients are mild and atypical,but with a lower positive rates of specific immunological indices and a higher mortality rate.Hence,special attention should be paid to SLE occurred in the elderly in order to avoid the misdiagnosis or missed diagnosis.
其他文献
我第一次摸羽毛球拍,还不到十岁,那时爸爸在军队工作,偶尔会带回家一些新奇玩意儿。有一天清早,他跑到我床头大喊:“懒猫,快起来了,今天爸爸教你打羽毛球!”我听到爸爸的喊声
1 病历摘要患者男,64岁。因龟头红斑半年,于2015年9月来我科就诊。患者半年前无明显诱因龟头出现红斑,无自觉症状,未经诊治,病灶逐渐增大。既往体健,个人史及家族史无特殊。
期刊
@@
赛道日讲究的是在自己能力范围内开心地玩,出一身汗,洗去平日里工作与生活中的烦恼和压力。所以,在力盛超级赛道节里,所有的参赛选手都是一种相对轻松愉悦的状态。8月6日,第
通过1例典型病例进一步认识复发性半环状丘疹性红斑的临床特点.该病常见于中青年男性,春夏季发病,多到秋冬季后可缓解,但来年易复发.皮疹主要表现为环状或半环状损害,边缘由
红先和五卒如五虎围住元帅,红方双车一马一兵未能攻破敌阵,不惜牺牲守和。请君试弈。上期《马炮建功》着法炮一进四,将4进1;前车进三,将4进1;后车平六,卒5平4;车九平六,将4退
期刊
@@
新中国成立以来,大连人先后有100多名足球运动员入选了中国国家队;在20世纪90年代初开始的中国足球职业联赛中,大连取得了8次冠军,还创造了55场不败的纪录。这些都创下了中国
报告1例带状疱疹继发瘢痕疙瘩.患者男,68岁.右侧胸背部红色隆起性斑块伴痛痒2年余.患者2年前无明显诱因下出现右侧前胸及后背异样感,伴发热、乏力,后逐渐形成局部水疱,误诊为
目的 :系统评价他克莫司软膏治疗儿童特应性皮炎的有效性及安全性。方法 :搜索电子数据库MEDLINE and PubMed、the Cochrane Central Register of Controlled(CENTRAL)、EMba
白塞综合征(BS)是一种慢性、可累及多系统的血管炎性疾病。临床上以口腔溃疡、生殖器溃疡、葡萄膜炎和皮肤损害等反复发作为主要特征,亦可累及胃肠道、关节、心血管、肾脏及
期刊
@@