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目的通过分析系统性红斑狼疮(SLE)并发假性肠梗阻(IPO)及输尿管肾盂积水患者的临床及实验室特点,以提高临床医生对此并发症的认识。方法回顾性分析本院2000—2005年SLE并发IPO患者10例,收集临床及实验室资料,分析其发病情况、病情活动情况及受累脏器、病程、治疗及预后特点。结果以肠梗阻为首发者3例,同时伴输尿管肾盂积水者7例(7/9),膀胱壁增厚、毛糙5例(5/9),伴有胆囊壁增厚或壁毛糙者6例(6/8)。抗核抗体阳性10例,抗dsDNA抗体阳性6例,抗SSA抗体阳性6例,抗核糖核蛋白(RNP)抗体阳性5例,抗心磷脂抗体IgG阳性4例(4/7)。所有病例均有血清补体C3和C4的降低。肠梗阻症状均在大剂量糖皮质激素治疗1周左右缓解。结论IPO常与输尿管肾盂积水及胆囊壁增厚相伴发,提示由内脏平滑肌受累本身运动障碍所致,及时使用肾上腺糖皮质激素治疗对于控制病情、改善预后非常重要,应避免不必要的手术干预。
Objective To improve the understanding of clinicians by analyzing the clinical and laboratory characteristics of patients with systemic lupus erythematosus (SLE) complicated with pseudo-intestinal obstruction (IPO) and ureteral hydronephrosis. Methods A retrospective analysis of 10 cases of SLE complicated with IPO in our hospital from 2000 to 2005 was conducted to collect clinical and laboratory data and analyze its incidence, disease activity and organ involvement, course of disease, treatment and prognosis. Results In 3 patients with intestinal obstruction, 7 patients (7/9) had ureter hydronephrosis, thickening of the bladder wall, and 5 cases of rough (5/9) with thickening of the gallbladder wall or rough wall 6 Example (6/8). 10 were positive for antinuclear antibody, 6 were positive for anti-dsDNA antibody, 6 were anti-SSA antibody, 5 were anti-ribonucleoprotein (RNP) antibody and 4 were anti-cardiolipin antibody IgG (4/7). Serum complement C3 and C4 were reduced in all cases. Intestinal obstruction symptoms were treated with high-dose glucocorticoid about 1 week ease. Conclusions IPO often associated with hydronephrosis of the ureter and gallbladder wall thickening accompanied by visceral smooth muscle involvement itself caused by dyskinesia, and timely use of glucocorticoid treatment for the control of the disease, improve the prognosis is very important, should avoid unnecessary surgical intervention .