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目的总结儿童狼疮性肺炎的临床特点,帮助早期诊断及改善预后。方法回顾性分析本院2010年1月-2011年12月收治的35例SLE患儿中4例并狼疮性肺炎患儿临床资料。4例均为女童,年龄5～11(8.2±2.3)岁,体质量(24.8±5.7)kg。比较其临床表现有无差异,记录狼疮性肺炎患儿ESR、CRP,降钙素原、补体C3和C4水平及血培养、痰培养结果,G试验、GM试验等指标,分析4例患儿胸部CT表现。4例患儿均予激素、环磷酰胺治疗。结果 4例患儿均有发热、咳嗽、气促、呼吸困难,三凹征阳性,肺部影像学改变,ESR、CRP、降钙素原均明显高于正常值,痰培养、血培养均为阴性,G试验、GM试验结果为阴性。给予环磷酰胺联合糖皮质激素治疗,4例均治愈。结论儿童狼疮性肺炎临床表现缺乏特异性,可结合影像学及实验室检查协助诊断,环磷酰胺联合糖皮质激素治疗有效。
Objective To summarize the clinical features of children with lupus pneumonia, to help early diagnosis and improve prognosis. Methods The clinical data of 4 children with lupus pneumonia in 35 children with SLE admitted to our hospital from January 2010 to December 2011 were retrospectively analyzed. All 4 patients were female, aged 5 to 11 (8.2 ± 2.3) years old, with a weight of (24.8 ± 5.7) kg. To compare the clinical manifestations, records of ESR, CRP, procalcitonin, C3 and C4 levels and blood culture, sputum culture results, G test, GM test and other indicators of children with lupus pneumonia, 4 cases of children with chest CT performance. 4 cases of children were treated with hormone and cyclophosphamide. Results All the 4 patients had fever, cough, shortness of breath, difficulty breathing, positive triple indentation, pulmonary imaging changes, ESR, CRP and procalcitonin were significantly higher than normal, sputum culture and blood culture were Negative, G test, GM test results were negative. Cyclophosphamide given glucocorticoid treatment, 4 cases were cured. Conclusions The clinical manifestations of lupus pneumonia in children are not specific. They can be combined with imaging and laboratory tests to diagnose the disease. The combination of cyclophosphamide and glucocorticoid is effective.