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目的探讨以血液系统症状为首发症状的系统性红斑狼疮(SLE)患者的临床特征。方法回顾性分析20例SLE患者的临床资料和实验室检查结果。结果本组患者临床表现及血象缺乏特异性,但所有患者均具备SLE相关的多种自身抗体阳性及不同程度的皮肤、黏膜、关节等症状,以贫血为主要表现者14例(70.0%),以出血为主要表现者9例(45.0%),以溶血性贫血为主要症状者2例(10.0%),白细胞减少者8例(40.0%),血小板减少者者11例(55.0%),全血细胞减少者4(20.0%)。骨髓形态学改变缺乏特异性。2例溶血性贫血患者Coombs试验均为阳性,尿蛋白阳性者12例(60.0%)。结论血液系统症状可以是SLE的早期表现,当患者以血液系统症状就诊时,临床医生应提高警惕性,可进行与SLE相关的检查,这对减少误诊率和提高诊断率至关重要。
Objective To investigate the clinical features of patients with systemic lupus erythematosus (SLE) who have hematologic symptoms as the first symptom. Methods Retrospective analysis of 20 cases of SLE patients with clinical data and laboratory test results. Results There were 14 cases (70.0%) with anemia as the main manifestations, including all kinds of autoantibodies positive to SLE and varying degrees of skin, mucosa and joint in all patients. Bleeding as the main performance in 9 cases (45.0%), hemolytic anemia as the main symptoms in 2 cases (10.0%), leukopenia in 8 cases (40.0%), thrombocytopenia in 11 cases (55.0%), all Cytopenia 4 (20.0%). Lack of specificity for bone marrow morphological changes. Two cases of hemolytic anemia Coombs test were positive, urinary protein positive in 12 cases (60.0%). Conclusions Hematological symptoms can be an early manifestation of SLE. Clinicians should be vigilant when they are referred for symptoms of hematologic disorders and may be associated with SLE, which is crucial for reducing the rate of misdiagnosis and improving the diagnosis.