系统性红斑狼疮肝损害的临床研究

摘要 目的：研究系统性红斑狼疮(SLE) 肝损害的发生率、临床表现及免疫学特点。方法：回顾分析452例SLE患者的临床资料,将有肝损害患者的临床表现、实验室检查结果与无肝脏损害的患者进行比较。结果：452例SLE患者中有肝损害53例(11.7%), 有肝损害组与无肝脏损害比较，两组临床和免疫学特点等表现差异无统计学意义（P＞0.05），但SLEDAI比较差异有统计学意义(P＜0.05)。53例患者中谷丙转氨酶（ALT）升高51例，谷草转氨酶(AST)升高48例，黄疸3例（5.7%）。经激素及免疫抑制剂治疗,同时予护肝治疗，绝大多数患者恢复良好。无1例死于SLE肝损害。结论：SLE本身所致的肝损害发生率并不低，与病情活动有关，对激素及免疫抑制剂敏感,预后较好。

Clinical study of Systemic lupus erythematosus with liver involvement

Objective To evaluate the incidence, clinical and immunological features of liver involvement in Systemic lupus erythematosus(SLE). Methods Clinical data of 452 cases of SLE with or without liver involvement was analyzed and compared retrospectively. Results 53 patients (11.7 %) with liver involvement could be etiologically ascribed to SLE itself. The rate of age , sex , course of disease ,ANA ,anti-Sm ,anti-dsDNA and serum IgG in patients with liver involvement did not show any difference from those without liver involvement （P＞0.05）. In the group of liver involvement , SLE disease activity index (SLEDAI) were higher than the group without liver involvement(P＜0.05) . Among the 56 cases with liver involvement , ALT raised in 51cases, AST in 48 cases, and 3 cases with cholestasis. Most cases were well recovered after treatment of glucocorticoid, immunosuppressive agent and liver protection drugs. Conclusion The occurrence of liver involvement in SLE is rather high. Patients response to corticosteroid treatment is favourable and their prognosis appears good.