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目的 :了解小儿系统性红斑狼疮 (SLE)贫血的临床及实验室检查特点 ,以减少及避免早期误诊。方法 :对 5 7例小儿SLE的临床资料进行回顾性研究 ,将其中 2 7例有贫血表现患儿的临床症状及实验室检查作一分析。结果 :5 7例小儿SLE中贫血发生率为 47 4% ( 2 7/ 5 7) ,伴Coombs阳性患儿常以贫血为首发症状或主要症状。AIHA组贫血程度较非AIHA组为重 ,网织红细胞增高比非AIHA组明显 ,P <0 0 5 ,有统计学意义 ,而白细胞计数、血小板数量两组比较无显著性差异 ;血沉和C反应蛋白等反映疾病活动度的指标亦无显著性差异 ;AIHA组血中补体C3 降低较非AIHA组明显 ,P <0 0 5 ,有统计学意义。结论 :贫血为SLE较为常见的症状 ,以自身免疫性溶血性贫血 (AIHA )为主要或首发表现的SLE患儿容易误诊。
Objectives: To understand the clinical and laboratory features of children with systemic lupus erythematosus (SLE) anemia to reduce and avoid early misdiagnosis. Methods: The clinical data of 57 pediatric patients with SLE were retrospectively studied. The clinical symptoms and laboratory tests of 27 children with anemia were analyzed. Results: The incidence of anemia in 57 children with SLE was 47 4% (27/57). Anemia was the first symptom or main symptom in Coombs positive children. The degree of anemia in AIHA group was heavier than that in non-AIHA group, and the increase of reticulocyte was significantly higher than that of non-AIHA group (P <0.05), while there was no significant difference between the two groups in the number of white blood cell count and platelet count. Protein and other indicators of disease activity index also showed no significant difference; AIHA blood complement C3 was significantly lower than non-AIHA group, P <0 05, with statistical significance. Conclusion: Anemia is a common symptom of SLE. Misdiagnosed patients with SLE with autoimmune hemolytic anemia (AIHA) as the primary or first manifestation may be misdiagnosed.