女性系统性红斑狼疮合并膝关节骨梗死的临床分析

目的 初步探讨女性系统性红斑狼疮合并膝关节骨梗死患者的临床特点，以便早期发现临床病例，及时防治。 方法 蚌埠医学院第一附属医院风湿免疫科2015年5月1日—2019年9月30日住院的女性系统性红斑狼疮患者合并膝关节骨梗死共24例，同期未发生骨梗死的系统性红斑狼疮患者836例作为对照组，其中系统性红斑狼疮均符合1997年美国风湿病学会制定的分类标准，骨梗死均由磁共振检测诊断。收集2组患者临床资料，对2组资料进行比较分析，以了解系统性红斑狼疮合并膝关节骨梗死的临床特点。 结果 与未合并骨梗死患者比较，系统性红斑狼疮合并膝关节骨梗死患者在皮疹、肾脏损害、雷诺现象、激素冲击治疗等方面差异具有统计学意义(P<0.05)，而在关节炎、浆膜炎、血液系统受累等方面差异无统计学意义(P>0.05)。2组间比较，出现骨梗死的SLE发病年龄更小(29.50±7.05)岁]，差异有统计学意义(P>0.05)。女性系统性红斑狼疮合并膝关节骨梗死患者与皮疹、肾脏病变、雷诺现象、激素冲击治疗存在一定相关性(r=0.078、0.080、0.080、0.094)；SLE患者合并单纯膝关节骨梗死与SLE膝关节骨梗死合并其他骨梗死各临床特点差异无统计学意义(P>0.05)。 结论 女性系统性红斑狼疮患者合并有皮疹、肾脏受累、雷诺现象、糖皮质激素冲击治疗、发病年龄小，应警惕膝关节骨梗死的发生。 

Clinical analysis of bone infarction of knee joint with female systemic lupus erythematosus

Objective To investigate the clinical characteristics of female patients with systemic lupus erythematosus (SLE) and bone infarction of knee joint, in order to detect early clinical cases, timely prevention and treatment. Methods A total of 24 female patients with SLE complicated with bone infarction of the knee joint were admitted to the department of rheumatology of our hospital from May 1st, 2015 to September 30th, 2019, and 836 patients with SLE without bone infarction were selected as control group. SLE conformed to the classification criteria established by the American College of Rheumatology in 1997, and bone infarction was diagnosed by MRI. Clinical data of the two groups were collected and analyzed to understand the clinical characteristics of SLE with bone infarction of the knee joint. Results Compared with patients without bone infarction, patients with SLE combined with bone infarction of the knee joint showed statistically significant differences in rash, kidney damage, Reynolds' phenomenon, and hormone shock therapy (P<0.05), while no statistically significant differences in arthritis, serosal inflammation, and blood system involvement (P>0.05). The age of SLE patients with bone infarction was younger(29.50±7.05) years], the difference was statistically significant between the two groups. Female patients with SLE complicated with bone infarction of the knee joint were associated with rashes, nephropathy, Raynaud's phenomenon, hormone shock therapy. The clinical characteristics of SLE patients with simple bone infarction of the knee joint and SLE bone infarction of the knee joint with other bone infarction showed no statistical significance (P>0.05). Conclusion Female patients with SLE have rash, renal involvement, Raynaud's phenomenon, and glucocorticoid shock therapy, while the age of onset is young. The occurrence of bone infarction of the knee joint should be alert.