| 摘要: |
| 目的:探讨男性儿童系统性红斑狼疮(SLE)的临床特点。方法:收集2006年1月至2015年8月住院的41例男性SLE患儿的临床资料,与同期204例女性患儿中年龄匹配的41例进行临床资料比较分析。结果:两组患儿在起病年龄、籍贯分布、家族史、首发临床表现、炎性指标及免疫学指标方面比较差异无统计学意义(P>0.05)。两组患儿的常见首发临床表现均为发热、皮疹、浮肿和关节肌肉疼痛。组内对比发现活动期红细胞沉降率(ESR)较C反应蛋白(CRP)的阳性率更高(P<0.05)。男女两组间蛋白尿、肾功能不全、血液系统损害、心脏损害和神经精神狼疮的发生率比较差异无统计学意义(P>0.05)。28 例男性和20例女性完善肾活检,两组病理分型均以郁型及以上为主。治疗上均以糖皮质激素和免疫抑制剂为主要药物。以SLEDAI评分系统对患者的转归进行评价,好转率男87.8%(36例),女82.9%(34 例),差异无统计学意义;病死率男4.9%(2例),女12.2%(5 例),差异无统计学意义。7例死亡患儿的起病年龄为(8.0±1.9)岁,显著低于总样本82例患儿的起病年龄的(11.2±2.5)岁(P<0.05)。结论:男性SLE患儿以发热、皮疹、浮肿和关节肌肉疼痛为常见首发表现,肾脏、血液、心脏、神经精神系统容易受累,狼疮肾炎以病理郁型及以上为主,起病年龄越小可能病情更危重。 |
| 关键词: 系统性红斑狼疮 男性 儿童 临床分析 |
| DOI：10.13407/j.cnki.Jpp.1672-108X.2017.04.004 |
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| 基金项目: |
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| Clinical Analysis of Systemic Lupus Erythematosus in 41 Male Children |
| Fu Hua, Tang Xuemei |
| (Children's Hospital of Chongqing Medical University, Chongqing 400014, China) |
| Abstract: |
| Objective: To explore the clinical features of male children with systemic lupus erythematosus (SLE). Methods: Forty one male and 204 female children with SLE were admitted from our hospital during January 2006 to August 2015. Forty one females were extracted from the 204 females to compare with 41 males. Results: No statistical differences were found in the age of onset, native place, family history of rheumatic disease, clinical initial manifestations, inflammatory indexs and immunological indexs between two
groups (P>0.05). The clinical initial manifestations were fever, rash, edema, pain in joints and muscles in both two groups. There were significant differences in positive incidence of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) (P<0.05) in intra-group comparison. No statistical differences were found in the incidence of proteinuria, renal insufficiency, blood system damage, cardiac damage and neuropsychiatric systemic lupus erythematosus (NPSLE) between the two groups (P>0.05). Type Ⅳ was the most common pathology classification of 28 male and 20 female children with renal biopsy. Glucocorticoids and immunosuppressants were the main medicines for treatment. Evaluated the outcomes by systemic lupus erythematosus disease activity index (SLEDAI) score system, the improvement rate of two groups were 87.8% (36 cases) in male group and 82.9% (34 cases) in female group (P>0.05). The mortality of two groups were 4.9% (2 cases of male) and 12.2% (5 cases of female) (P>0.05). Average onset age of the 7 dead cases was (8.0±1.9) years old, which was younger than the average onset age (11.2±2.5) years old of total 82 cases (P<0.05). Conclusion: Male SLE children usually take fever, rash, edema, joints and muscles pain as the major initial manifestations. Urinary system, blood system, cardiac system and neuropsychopathic system are easily involved. Type Ⅳ is the most common pathology classification in the male children with lupus nephritis. The younger onset age might indicate a worse prognosis. |
| Key words: systemic lupus erythematosus male chidren clinical analysis |
