摘要
目的 分析系统性红斑狼疮 (SLE)罕见的临床并发症———假性肠梗阻 (IPO) ,以引起临床医师重视。方法 结合文献复习 ,回顾性分析北京协和医院 6年来SLE合并IPO患者 10例。结果 10例女性患者平均年龄 2 9.4岁 (14～ 5 0岁 ) ,SLE诊断均符合 1982年美国风湿病协会关于SLE的诊断标准 ,并无硬皮病和重叠综合征的临床表现 ,无腹部手术史。所有患者抗核抗体滴度增高 ,其中 4例为轻度增高 ,双链DNA阳性 5例。 6例IPO为SLE内脏病变的首发症状 ,并同时伴有肾盂积水、输尿管扩张 ,其中 1例死于肠穿孔。结论 IPO是SLE的一个罕见但严重的并发症 ,由内脏平滑肌受累运动障碍所致 ,自身抗体谱有其特点。及早诊断 。
Objective To document intestinal pseudo obstruction(IPO) as a recognized rare clinical manifestation of systemic lupus erythematosus(SLE). Methods Ten cases of IPO in SLE patients in Peking Union Hospital were analyzed retrospectively. Results All the 10 female patients conformed to the American College of Rheumatology(ACR) revised classification criteria for SLE, without any clinical features of scleroderma or overlap syndrome. No history of abdominal operation was recorded in those patients. The mean age of IPO onset was 29.4 year(14 50 year). In six patients, IPO was an initial visceral lesion symptom of SLE, accompanied by bilateral ureterectasia. One patient died from intestinal perforation. All cases were ANA(+), five dsDNA(+), eight SSaAb(+), two rRNP(+) and two RNP(+). Conclusions IPO is a rare but important complication of SLE, and its underlying pathology is not fully clear. The finding of coexisting ureterohydro nephrosis suggests that there may be visceral smooth muscle motility problem which may be secondary to vasculitis. Recognition and treatment of IPO in SLE in time are very important for the patient's prognosis.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2003年第12期744-747,共4页
Chinese Journal of Digestion
