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目的系统性红斑狼疮(systemic 1upus erythematosus,SLE)患者的合并自身免疫性溶血性贫血的分析。方法回顾性分析我院2009年1月-2012年1月收治的15例SLE患者,均以自身免疫性溶血性贫血(autoimmune hemolytic anemia,AIHA)为首发症状,行血象、骨髓象、血清铁、网织红细胞计数及Coombs’试验。结果 Hb正常者3例(20.0%),贫血者12例(80.0%),WBC减少5例(33.3%),血小板减少5例(33.3%)。骨髓增生明显活跃者14例(93.3%),骨髓增生减低1例(6.7%),降低患者伴全血细胞减少;血清铁测定,正常者3例(20.0%),降低者12例(80.0%);网织红细胞计数升高10例(66.7%),减低3例(20.0%),正常2例(13.3%);Coombs’试验:15例中直接抗体阳性11例(73.3%),抗C3与抗IgG抗体均阳性6例(40.0%),其中抗C3阳性5例(33.3%)。结论 SLE为育龄女性多发病,本组女性患者为93.3%(14/15),其中育龄患者为66.7%(14/15),SLE合并AIHA常合并血液系统异常,本组Hb减少占80.0%(12/15),同时合并WBC与PLT减少,各占33.3%(5/15),因此如果出现血液系统异常,则需进行SLE的相关筛查。
Objective To analyze the autoimmune hemolytic anemia in patients with systemic lupus erythematosus (SLE). Methods Fifteen patients with SLE admitted to our hospital from January 2009 to January 2012 were retrospectively analyzed. Their autoimmune hemolytic anemia (AIHA) was the first symptom, and blood, bone marrow, serum iron, Reticulocyte count and Coombs’ test. Results There were 3 cases (20.0%) with normal Hb, 12 cases (80.0%) with anemia, 5 cases (33.3%) with WBC reduction and 5 cases (33.3%) with thrombocytopenia. Myeloid hyperplasia was significantly active in 14 cases (93.3%), bone marrow hyperplasia in 1 case (6.7%), reduce patients with pancytopenia; serum iron determination, normal in 3 cases (20.0%), decreased in 12 cases (80.0% ; Reticulocyte count increased in 10 cases (66.7%), decreased in 3 cases (20.0%), normal in 2 cases (13.3%); Coombs’ test: 15 cases of direct antibody positive in 11 cases (73.3% Anti-IgG antibodies were positive in 6 cases (40.0%), of which anti-C3 positive in 5 cases (33.3%). Conclusions SLE is a frequently-occurring disease in women of childbearing age. The female patients in this group were 93.3% (14/15), of whom 66.7% (14/15) in child-bearing age. SLE combined with AIHA often had abnormal blood system. Hb decreased by 80.0% 12/15). In the meantime, the combined WBC and PLT were reduced, accounting for 33.3% (5/15) each. Therefore, SLE related screening should be performed in case of abnormal blood system.