系统性红斑狼疮合并肝损害的临床分析

目的探讨系统性红斑狼疮患者肝脏损害的临床特点，加深对狼疮肝病的认识。方法回顾分析82例SLE有肝损害患者与无肝损害患者的临床资料，其中SLE合并肝损害42例，分为有肝损害组和无肝损害组。将有肝损害患者的临床表现、实验室检查结果与无肝损害的患者进行比较。同时，将系统性红斑狼疮患者肝纤维化4项指标和肝功能指标进行检测。结果系统性红斑狼疮组与对照组层粘连蛋白、血清Ⅲ型前胶原氨基端肽、丙氨酸氨基转移酶、天门冬酸氨基转移酶、碱性磷酸酶及总胆红素指标的比较差异有显著性（P〈0．05）；两组比较肝脏超声影像学特点有显著性差异（P〈0．05）；C反应蛋白、血沉、SLEDAI积分与对照组比较无统计学意义（P〉0．05）。结论系统性红斑狼疮肝损害，以肝细胞损害为主。系统性红斑狼疮患者的肝损害可能是多因素的，应明确病因，合理地使用激素和免疫抑制药物。

Clinical Analysis on Liver Damage in Patient with SLE

Objective To investigate the status of liver damage in patient with SLE and the characteristic of immunity using TCM and Western medicine to deal with liver damage in patient with SLE so that to deepen the information of this disease.Methods Clinical data of 82 cases of SLE patient with or without liver deteriment were analyzed and compared retrospectively.The levels of indexes of liver fibrosis and functions in 42 patients of SLE were detected with or without liver deteriment and was analyzed and compared retrospectively.Results The lab data of liver function in SLE group were higher than those in control group with P<0.05.The ultrasound characteristics of liver damage had difference than non-liver damage P<0.05.The c-reaction protein,ESR and SLEDAI had no difference between two groups.Conclusion The liver damage in SLE might be mainly lever cell damage that involves multiple factors.The reasonable hormone and immuno-inhibitor should be used.