系统性红斑狼疮并发假性肠梗阻5例临床分析

目的分析系统性红斑狼疮（SLE）并发假性肠梗阻（IPO）患者的临床表现及实验室检查，以提高临床医生对SLE并发IPO认识。方法回顾性分析我院2004—2007年7月收治的SLE并发IPO5例，收集临床及实验室特点，分析其发病情况、受累脏器、治疗及预后。结果以假性肠梗阻为首发者2例，伴有肾孟积水2例。有腹水及狼疮肾炎5例，血液系统受累4例。抗核抗体阳性5例，抗dsDNA抗体阳性4例，5例均C3下降。4例肠梗阻症状在1周左右缓解，1例死亡。结论SLE并发IPO患者病情较重，常伴有其他脏器受累，及时诊断和大剂量激素联合免疫抑制剂治疗对控制病情、改善预后非常重要。

Clinical Analysis on 5 Cases of Systemic Lupus Erythematosus Associated with Intestinal Pseudo Obstruction

Objective To analyze the clinical features and results of laboratory examine hoping for understanding clearly of systemic the lupus erythematosus（SLE） associated with intestinal pseudo obstruction（IPO）. Methods The clinical manifestations, laboratory and serologic abnormalities,internal organs involved, treatment and prognosis of 5 SLE with IPO were analyzed retrospeetively. Results Among the 5 cases of SLE with IPO, two cases presented with IPO as the initial manifestation of SLE,2 had ureterohydronephrosis ,5 had aseites and lupus nephritis ,and 4 had hematological system involvement. All cases were antinuelear antibody（ANA） positive ,4 had positive anti-dsDNA. C3 decreased in all the 5 cases. IPO responded readily to therapy within one week in four patients. One case died. Conclusions Intestinal obstruction is a life-threatening complication of SLE, usually associated with muhisystem activity. The early diagnosis and the treatment associating glucocorticoids with immunosuppressive is helpful to the disease controlling and prognosis improving.