摘要:目的:探討系統性紅斑狼瘡（SLE）肝損害的臨床特點、肝損害發生率與SLE的病情嚴重程度的關系。方法:對98例SLE的臨床資料進行分析,收集所有研究對象的臨床資料,對肝損害組(30例)的癥狀與體征、病情程度、肝功能指標、影像學檢查結果進行數據分析,并將其部分生化及免疫學指標與無肝損害組(68對照組)進行比較。結果:SLE患者中SLE肝損害的發生率為30.61%。肝損害組中,病情重度16例(53.33%),17例患者(56.67%)無明顯自覺癥狀,以ALT、AST輕中度升高為主。7例患者肝臟B超異常。肝損害組患者的白細胞值明顯低與無肝損害組(P lt;0.05)。而2組的血紅蛋白、血小板、CRP、ESR、抗核抗體、抗dsDNA抗體、IgG、補體3等比較差異均無統計學意義(P均 gt;0.05)。11例患者接受腎上腺皮質激素(激素)、免疫抑制劑(環磷酰胺、甲氨蝶呤)等藥物治療,9例在出院時復查肝功能正常或好轉,另2例肝功能無明顯改善;19例患者在接受激素、免疫抑制劑治療的同時,給予護肝治療,15例出院復查肝功能正常或好轉,另4例無明顯改善。而對照組68例中病情重度8例(11.76%)。結論:肝臟是SLE常見累及的靶器官之一,SLE肝損害的臨床表現缺乏特異性,以輕至中度肝細胞損害多見,肝損害發生率與SLE病情嚴重程度成正相關、與SLE的近期預后無關、與長期預后有待進一步研究。
Abstract: Objective: To discuss the relationship between the clinical characteristic, The incidence of liver damage and the severity of SLE. Methods: Carries on the mathematical analysis to 98 example SLE clinical material, the collection all object of study clinical material, to liver harm group (30 examples) the symptom and the symptom，Severity the liver function target， the phantom study inspection result carries on the mathematical analysis, and (68 control groups) carries on its part of biochemistry and the immunology target with the nonliver harm group the comparison.Results: In the SLE patient the SLE liver harms the formation rate is 30.61%.In liver harm group, severe illness in 16 cases (53.33%), 17 example patient (56.67%) not obvious subjective symptom, by ALT, AST light moderate ascension primarily.7 example patient liver B ultra exceptionally.The liver harm group patient’s white blood cell value is lower than the nonliver harm group obviously (P lt;0.05), but 2 groups of hemoglobins, the blood platelet, CRP, ESR, the antinuclear immune body, the antidsDNA immune body, IgG, the complement 3 and so on the comparison differences do not have statistics significance (P gt;0.05). 11 example patients accept the adrenal cortex hormone (hormone), the immunity inhibitor (endoxan, armor ammonia pterin) and so on the medicine treatments, 9 examples when out of hospital reexamines the liver function normal or the change for the better, another 2 example liver function improves not obviously; 19 example patients while accept the hormone, immunity inhibitor treatment, gives protects the liver treatment, 15 example out of hospital reexamination liver function normal or change for the better, another 4 examples improve not obviously. While the control group, 68 cases of severe illness in 8 cases (11.76%).Conclusion: The liver is one of target organs which SLE implicates common, the SLE liver harm. the clinical manifestation lacks the specificity, by sees lightly to the moderate liver cell harm,The incidence of liver damage and SLE severity is positively correlated with shortterm prognosis of SLE has nothing to do with the longterm prognosis remains to be further studied.

Citation： XU Yinglin.. The Systematic Lupus Erythematosus Liver Harms 30 Examples Clinically To Analyze. West China Medical Journal, 2009, 24(11): 3007-3009. doi: Copy

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