系统性红斑狼疮并发蛛网膜下腔出血的临床特点

目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)并发蛛网膜下腔出血(subarachnoid hemorrhage,SAH)患者的临床特点及预后。方法总结分析1983年1月至2012年1月就诊于北京协和医院的12例SLE并发SAH患者的临床资料。结果 SLE并发SAH患者住院期间的病死率高达42%(5/12)。SLE并发SAH的症状以头痛为主(75%)。系统性红斑狼疮疾病活动指数平均为(17.5±4.5)分。死亡患者在SAH发生早期即出现意识障碍者占80%(4/5),合并严重感染者占60%(3/5)。结论 SAH是SLE的少见且致命的并发症。对于出现意识障碍或合并感染的SLE患者,应当提高警惕,积极治疗SLE原发病及SAH,提高生存率。

Clinical Features of Systemic Lupus Erythematosus with Subarachnoid Hemorrhage

Objective To analyze the clinical characteristics and factors affecting the prognosis of systemic lupus erythematosus （SLE） patients with subarachnoid hemorrhage （SAH）. Methods We reviewed 12 medical records of SLE with SAH admitted patients at the Peking Union Medical College Hospital from 1983 to 2012 and analyzed the clinical data. Results The in-hospital fatality rate was quite high （42%）. Headache was the most common symptom （75%）. The mean （ ＋ SE） SLEDAI was 17.5 ± 4.5. Disturbance of consciousness and serious infection occurred in 4/5 （80%） and 3/5 （60%） of the non-survived group. Conclusions SLE with SAH was a rare but lethal condition. Patients flare up with disturbance of consciousness and accompanied with infection should be monitored.