系统性红斑狼疮消化系统损害43例报告

198 0年 6月至 1999年 6月 ,我院收治了系统性红斑狼疮 (SL E)消化系统损害患者 4 3例。现将诊治情况报告如下。临床资料 :本组均符合 1982年美国风湿病协会制定的诊断标准 ,其中男 3例 ,女 4 0例 ;年龄 16～ 6 7岁 ,平均 4 0 .2岁 ;病程 4～ 76个月。临床表现为食欲下降 13例 ,腹泻 10例 ,恶心、呕吐 7例 ,腹痛 7例 ,便秘 8例 ,腹胀 5例 ,黄疸 2例 ,呕血、黑便 1例。查体上腹压痛 9例 ,腹水征阳性 5例 ,肝肿大 13例 ,脾肿大 9例 ,黄疸 2例 ;伴发热 30例 ,关节痛 2 5例 ,皮疹19例。实验室检查示 AL T、AST升高 2 0例 ,γ- GT升高 7例 ,…     

泌乳素与自身免疫性疾病

泌乳素与自身免疫性疾病杨岫岩尹培达近年的研究发现，泌乳素（ｐｒｏｌａｃｔｉｎ，ＰＲＬ）与多种自身免疫性疾病相关，被誉为免疫调节激素，成为联系神经内分泌与免疫系统的焦点，日益受到关注。一、ＰＲＬ与免疫系统某些垂体激素可以影响免疫系统，ＰＲＬ和生长激素（...     

自身免疫性疾病与衰老

自身免疫性疾病(AID)的发病机制涉及机体的炎症反应;而炎症通路亦是衰老的机制。AID的临床观察显示出老年性疾病年轻化的证据。本文综述AID合并衰老相关疾病,如心脑血管疾病、糖尿病和骨质疏松症等相关文献进展,并简要阐述相关机制,促进两个研究领域的学科交叉。     

丙型肝炎与自身免疫性疾病

血清中存在自身抗体是丙型肝炎患者肝外自身免疫现象主要表现之一。此外还可伴有混合性冷球蛋白血症、肾小球肾炎、迟发性皮肤卟啉症、干燥综合征(sjogren’s综合征)、自身免疫性甲状腺炎、扁平苔癣、特发性血小板减少症等自身免疫性疾病。丙型肝炎病毒(HCV)相关的自身免疫性疾病易发生于老年、女性、HCV持续感染及伴有肝硬化的患者,但其发病机制至今尚未阐明,治疗策略也是我们将要面对的问题。 1．混合性冷球蛋白血症：其发生与HCV感染有关,主要是由于一种B淋巴细胞的良性增殖以及循环免疫复合物沉积于中小血管引起,导致多种器官和组织的病理损害。临床表现呈多样性,常见有紫癜、关节痛、全身性脉管炎、肾小球肾炎及周围神经性病变等。HCV感染可能在混合性冷球蛋白血症的发生中起重要作用。近90％的混合性冷球蛋白血症患者HCV     

以消化系统症状为首发表现的系统性红斑狼疮临床特征分析

目的 分析以消化系统症状为首发表现的系统性红斑狼疮(SLE)患者的临床特征.方法 采用回顾性方法 ,选取2004年7月至2009年6月因不明原因腹痛、腹泻等消化系统症状入消化科住院并最后确诊为SLE的患者为研究对象(研究组),并按1:2比例选取以发热、关节痛等为主诉的风湿免疫科同期住院SLE患者作为对照组,对临床特征进行比较分析.结果 共收集到研究组31例(其中女性27例)、对照组62例(其中女性55例).经多因素分析后发现,研究组以腹痛(OR=7.91)和腹泻(OR=6.26)症状最为常见,确诊之前的病程较对照组长(OR=1.41),体重下降较对照组明显(OR=1.37),但红细胞沉降率(ESR)增快(OR=0.88)和尿红细胞阳性(OR=0.56)不如对照组明显.结论 临床应注意识别以消化系统症状为首发表现的SLE患者,以减少误诊和漏诊.     

系统性红斑狼疮的消化系统表现及其诊治

系统性红斑狼疮(SLE)是一个多系统受累的自身免疫病.SLE消化系统症状发生率为25%～50%,约10%SLE患者以消化系表现为首发症状[1].SLE消化系统累及发生率高,不具特异性,并且与感染、药物、血栓形成等原因引起的症状鉴别困难,易误诊,尤其是以消化系统症状为首发表现的SLE更易误诊[2].     

自身免疫性疾病与寄生虫感染引起心包损害20例临床分析

198 7～ 2 0 0 1年我们收治自身免疫性疾病与寄生虫感染引起的心包损害患者 2 0例 ,其中白塞氏病伴发心包损害 2例 ,系统性红斑狼疮 (ＳＬＥ) 4例 ,类风湿性关节炎 3例 ,丝虫病 3例 ,阿米巴病 6例 ,流行性出血热 2例。临床资料1.一般资料 :上述少见病因心包损害共 2 0例 ,年龄 14～ 5 3岁 ,平均年龄 3 3 .5岁 ,病程 7天～ 2年 ,女性 10例 ,男性 10例。2 .白塞氏病并发心包损害 :2例均为女性 ,年龄分别为 2 5岁和 3 7岁 ,均因低热、口腔溃疡、结膜炎和外阴溃疡入院。其中 1例伴有肢关节酸痛和皮肤结节红斑 ,病程分别为半年和 1个月。均在口腔…     

系统性红斑狼疮的消化系统表现63例

系统性红斑狼疮的消化系统表现６３例李易韩盛玺沈通良四川省人民医院消化内科６１００７２ＳｕｂｊｅｃｔｈｅａｄｉｎｇｓＬｕｐｕｓｅｒｙｔｈｅｍａｔｏｓｕｓ，ｓｙｓｔｅｍｉｃ／ｄｉａｇｎｏｓｉｓＤｉｇｅｓｔｉｖｅｓｙｓｔｅｍｄｉｓｅａｓｅｓ／ｅｔｉｏｌｏ...     

干燥综合征的消化系统表现

干燥综合征的消化系统表现黄梅芳，邓长生口眼干燥关节炎综合征（Ｓｊｏｇｒｅｎ＇ｓｓｙｎｄｒｏｍｅ，ＳＳ）简称干燥综合征，是外分泌腺的自身免疫性炎住疾病，其病因可能与病毒感染有关［１］．本病分原发住和继发性二类，原发性ＳＳ指无其它原因可寻者，继发性ＳＳ常...     

系统性红斑狼疮患者消化系统受累的临床特点及危险因素分析

目的:研究SLE患者合并消化系统受累的临床特点及预后不良因素,提升医务工作者对SLE合并消化系统受累的认知。方法:回顾性收集2012年9月1日至2019年9月1日我院收治的SLE住院患者的资料,分为2组,有消化系统病变的为消化系统受累组243例,随机抽取无消化系统病变的患者为对照组486例,采用 t检验、秩...     

Systemic Autoimmune Diseases in Patients Hospitalized with COVID-19 in Spain: A Nation-Wide Registry Study

We aimed to evaluate the clinical outcome of Systemic Autoimmune Diseases (SADs) patients hospitalized with COVID-19 in Spain, before the introduction of SARS-CoV-2 vaccines. A nationwide, retrospective and observational analysis of the patients admitted during 2020, based on the ICD10 codes in the National Registry of Hospital Discharges, was performed. Among 117,694 patients, only 892 (0.8%) presented any type of SAD before COVID-19-related admission: Sjogren’s Syndrome constituted 25%, Systemic Vasculitides 21%, Systemic Lupus Erythematosus 19%, Sarcoidosis 17%, Systemic Sclerosis 11%, Mixed and Undifferentiated Connective Tissue Disease 4%, Behçet’s Disease 4% and Inflammatory Myopathies 2%. The in-hospital mortality rate was higher in SAD individuals (20% vs. 16%, p < 0.001). After adjustment by baseline conditions, SADs were not associated with a higher mortality risk (OR = 0.93, 95% CI 0.78–1.11). Mortality in the SADs patients was determined by age (OR = 1.05, 95% CI 1.04–1.07), heart failure (OR = 1.67, 95% CI 1.10–2.49), chronic kidney disease (OR = 1.29, 95% CI 1.05–1.59) and liver disease (OR = 1.97, 95% CI 1.13–3.44). In conclusion, the higher COVID-19 mortality rate seen in SADs patients hospitalized in Spain in 2020 was related to the higher burden of comorbidities, secondary to direct organ damage and sequelae of their condition. Whilst further studies should evaluate the impact of baseline immunosuppression on COVID-19 outcomes in this population, efforts should be focused on the optimal management of SAD to minimize the impact of the organ damage that has been shown to determine COVID-19 prognosis.     

Organ specific and multisystemic autoimmune disease: part of a spectrum which may coexist in the same patient

Summary Five patients are described who were found to have both systemic lupus erythematosus and autoimmune thyroid disease. The coexistence of nonorgan specific and organ specific autoimmune disease is discussed.     

粪便钙卫蛋白在全消化系统疾病鉴别诊断中的意义

背景：粪便钙卫蛋白（FC）对鉴别诊断肠道炎症性疾病有较高的临床价值,但其在全消化系统疾病中的意义尚不完全清楚。目的：探讨FC在全消化系统疾病鉴别诊断中的意义。方法：纳入2011年6～8月南京军区南京总医院溃疡性结肠炎、克罗恩病、结肠息肉、肠易激综合征、食管炎、食管息肉、慢性胃炎、胃、十二指肠溃疡、急性胰腺炎、胃淋巴瘤患者共47例,以12名健康人作为对照,采用ELISA方法测定FC水平。以受试者工作特征（ROC）曲线分析FC检测的诊断效能。结果：在下消化道疾病中,溃疡性结肠炎和克罗恩病患者的FC水平显著高于结肠息肉和肠易激综合征患者（P〈0．01）．FC检测鉴别这两组疾病的ROC曲线下面积为0．952。食管炎、食管息肉、胃淋巴瘤患者的FC水平显著高于慢性胃炎、胃、十二指肠溃疡、急性胰腺炎患者（P〈0．01）。结论：FC作为一种非侵入性检测方法,对消化系统疾病的鉴别诊断具有一定临床价值。     

Gastric Carcinoid in a Young Woman with Systemic Lupus Erythematosus and Atrophic Autoimmune Gastritis

Background: Gastric carcinoid is a rare tumour that is associated with chronic atrophic gastritis in the majority of cases. It usually occurs in the 6th or 7th decade of life and is rarely diagnosed in patients under 30 years of age. Methods: We describe a case of multiple gastric carcinoids in a 23-year-old woman with systemic lupus erythematosus and atrophic autoimmune gastritis--an association that has not been reported previously. Results: The combination of atrophic autoimmune gastritis and gastric carcinoid with other autoimmune disorders has rarely been reported in the English medical literature. Conclusion: The fact that it mostly concerns (relatively) young patients may suggest a potential causative relation between those autoimmune disorders and the early development of atrophic gastritis with hypergastrinaemia, which subsequently leads to the occurrence of gastric carcinoid tumours at a young age.     

腹腔镜在消化系统疾病诊治中的应用进展

腹腔镜具有创伤小、康复快的优势,已成为外科医师的有力工具。随着腹腔镜器械不断改善、操作技巧的积累,以及对内镜操作技术的娴熟,消化内科医师已尝试将腹腔镜运用于消化系统疾病的诊治中,尤其双镜结合治疗取得了一定的成功。本文就腹腔镜在消化系统疾病诊治中的应用进展作一综述。     

肠道菌群调节在消化系统疾病治疗中的应用

肠道微生态系统对机体正常功能的发挥起至关重要的作用。肠道菌群失调参与人体各系统多种疾病的发病过程,益生菌制剂和粪便菌群移植技术因能有效调节肠道菌群且无明显不良反应而成为当今疾病治疗研究的热点课题。本文就肠道菌群调节在消化系统疾病治疗中的应用情况作一综述。     

免疫介导消化系统疾病在我国的诊治现状以及今后发展方向

随着我国经济的发展和国民生活习惯的改变,免疫介导消化系统疾病的发病率呈上升趋势,由于其临床表现具有复杂性、多样性、多变性,个体差异大,常可累及多个器官,并反复发作,迁延不愈,已越来越受到医学界的重视。我们在充分认识免疫介导消化系统疾病诊治现状的同时,需要多学科的共同努力,提高其诊治水平。     

Anticardiolipin antibodies in patients with autoimmune diseases: Isotype distribution and clinical associations

Summary A prospective study of IgG and IgM isotypes of anticardiolipin antibodies (aCL) was performed in a series of 167 patients with various autoimmune diseases, including rheumatic and nonrheumatic disorders, and in a group of 100 healthy blood donors. The IgG aCL serum was regarded as positive if a binding index (BI) greater than 2.85 (3.77 SD) was detected and a BI greater than 4.07 (3.90 SD) was defined as positive for IgM aCL. Forty patients (24%) were found to be positive for IgG and/or IgM aCL. IgG aCL were detected in 23% of patients with systemic lupus erythematosus (SLE), in 9% with idiopathic thrombocytopenic purpura, in 7% with progressive systemic sclerosis, and in 6% with dermatomyositis-polymyositis. IgM aCL were present in 43% patients with primary biliary cirrhosis, in 33% with rheumatoid arthritis, in 22% with SLE, and in 8% with giant-cell arteritis. IgG aCL were found to have a significant association with thrombosis and thrombocytopenia, and IgM and aCL with haemolytic anaemia and neutropenia, in SLE but not in the other autoimmune diseases. The identification of these differences in the aCL isotype associations, depending on the autoimmune disorder, may improve the clinical usefulness of these tests.     

消化系肿瘤干细胞标记物的研究进展

肿瘤干细胞假说从一个新的角度认识肿瘤,对消化系肿瘤干细胞进行全面地了解、鉴定和纯化可为消化系肿瘤的治疗带来新的方向,其中充分认识消化系肿瘤干细胞标记物是其基础,并可进一步证实肿瘤干细胞的存在以及选择有效的抗肿瘤靶向药物。本文就消化系肿瘤干细胞标记物的研究进展作一综述。     

Immune Components of Liver Damage Associated with Connective Tissue Diseases

Autoimmune connective tissue diseases are associated with liver abnormalities and often have overlapping pathological and clinical manifestations. As a result, they can present great clinical challenges and evoke questions about diagnostic criteria for liver diseases. Moreover, discriminating between liver involvement as a manifestation of connective tissue disease and primary liver disease can be challenging since they share a similar immunological mechanism. Most patients with connective tissue diseases exhibit liver test abnormalities that likely result from coexisting, primary liver diseases, such as fatty liver disease, viral hepatitis, primary biliary cirrhosis, autoimmune hepatitis, and drug-related liver toxicity. Liver damage can be progressive, leading to cirrhosis, complications of portal hypertension, and liver-related death, and, therefore, must be accurately identified. In this review, we highlight the challenges facing the diagnosis of liver damage associated with connective tissue disease and identify immune mechanisms involved in liver damage associated with connective tissue diseases.