巨核细胞程序性死亡在系统性红斑狼疮合并血小板减少机制中的研究进展

系统性红斑狼疮（systemic lupus erythmatosus,SLE）是一种以免疫炎症为特点的自身免疫性疾病,血小板减少是SLE常见的血液系统表现之一。SLE合并血小板减少的发病机制一直是研究的难点与热点。随着细胞的程序性死亡与SLE及自身免疫性疾病关系的研究,巨核细胞程序性死亡在SLE合并血小板减少的作用显得尤为重要。本文就巨核细胞程序性死亡在SLE合并血小板减少中发病中的研究进展作一综述。     

六项自身抗体联合检测在系统性红斑狼疮诊断中的价值

SLE是一种伴有多器官多系统损伤的自身免疫性疾病,以自身抗体的产生和免疫复合物的聚集为特征.其临床表现复杂和多样化,不典型的或早期的SLE易被误诊为其他疾病,ANA是筛查自身免疫性疾病不可或缺的自身抗体.SLE免疫学的显著特点为出现ANA[1]现行的SLE的实验室检查主要通过检测血清中的ANA、抗-ds-DNA、抗Sm等,后两项为SLE的特异性指标,但阳性率低,而ANA尽管阳性率高,但特异性又不好,近几年来,越来越多的学者认为AnuA、AHA、抗r-RNP也是SLE的诊断标志.本研究旨在评价抗Sm抗体、抗ds-DNA抗体、抗r-RNP抗体、AnuA、AHA、ANA在诊断SLE中的临床意义及自身抗体联合检测在SLE诊断中的意义及临床价值.     

系统性红斑狼疮患者肺部感染护理

系统性红斑狼疮（SLE）是以自身抗体的形成，免疫复合物的沉积为特点的系统性自身免疫性疾病。本文对186例SLE并发肺部感染患者的病原学检查、治疗及护理体会做一回顾性研究，结果肯定了整体护理在SLE并发肺部感染护理过程中的作用与地位。     

系统性红斑狼疮患者IL-6、IL-8和IL-10检测的意义

系统性红斑狼疮(SLE)是一种以免疫系统失调为特征的系统性自身免疫性疾病,涉及T淋巴细胞和B淋巴细胞的过度活动、自身抗体的产生以及免疫复合物的形成,这些免疫复合物通过沉积在细胞内引起器官损伤.越来越多的研究表明白介素在SLE的发生、发展和转归中发挥着重要的作用.本文报告SLE患者IL-6、IL-8和IL-10检测结果,...     

T细胞异常活化在系统性红斑狼疮中的分子免疫机制

系统性红斑狼疮(SLE)是一种系统性自身免疫性疾病,其发病机制错综复杂。T细胞参与SLE自身免疫的启动和整个过程,且直接促进SLE受累器官的病理改变。其活化异常引起的细胞因子产生失衡、自身反应性T细胞持续存在、T细胞凋亡增加等,在SLE发病机制中发挥关键的作用。本文就近年来发现的SLE患者中T细胞活化在细胞膜信号,胞内激酶和转录因子等各个水平的异常及其对SLE发生发展的影响加以综述。     

以急性腹痛、恶心、呕吐为首发症状SLE 2例报道

系统性红斑狼疮（SLE）是多器官系统的自身免疫性疾病，临床表现复杂，并发症较多，近年来我们遇到以消化系统症状为首发表现的SLE2例，现报告如下。     

以癫痫为首发症状的系统性红斑狼疮误诊2例分析

目的探讨以癫痫为首发症状的SLE误诊原因。方法通过2例以癫痫为首发症状SLE诊断过程分析。结果 SLE是一种累及多系统自身免疫疾病,可累及中枢神经系统,临床表现复杂,但以癫痫为首发症状起病的SLE少见,容易误诊。结论癫痫发作,均见于SLE活动期,即使无其他系统累及,尤其青、中年女性病因不明的癫痫,应常规进行有关SLE检查,从而避免漏诊与误诊。     

系统性红斑狼疮合并结核56例的饮食护理

系统性红斑狼疮（SLE）是一种临床表现有多系统损害症状的慢性系统性自身免疫性疾病。SLE患者大多存在免疫功能低下，容易并发结核。无论是结核还是SLE，饮食护理均是护理工作的重要内容，两种疾病同时发病后其饮食更为复杂多变，必须有专业的饮食护理，以促进疾病康复。笔者长期致力于这方面的工作，现总结对SLE合并结核患者的饮食护理经验，报道如下：     

抗核小体抗体与抗双链DNA在狼疮肾炎血清的表达及其临床意义

系统性红斑狼疮（SLE）是一种累及多系统、多器官的自身免疫性疾病,患者突出表现有多种自身抗体。狼疮肾炎（LN）是SLE最常见的并发症。有资料表明对SLE患者进行肾穿检查,几乎所有的SLE均有程度不等的肾脏病变,SLE患者肾脏受累和进行性肾功能损害仍是SLE死亡的主要原因。     

系统性红斑狼疮患者接种新型冠状病毒疫苗的建议及依据

在新型冠状病毒肺炎(COVID-19)疫情持续的当下,自身免疫性疾病导致的免疫异常和应用免疫抑制剂治疗导致的免疫功能低下,使得系统性红斑狼疮(SLE)患者对新型冠状病毒(SARS-CoV-2)的易感性更高.同时,感染是SLE患者死亡的重要危险因素,也可导致SLE患者病情活跃、恶化进而使预后更差.但是,目前SLE患者接种...     

Treatment of systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease with clinical manifestations involving a multitude of tissue sites. This article describes the pathophysiology, etiology, clinical manifestations, and therapy of SLE, and focuses mainly on drugs used in SLE treatment. The reader will be able to identify which pharmacologic agents are used in SLE and list the drugs that are useful for specific clinical manifestations. The reader will also be able to describe the common adverse drug reactions seen from SLE treatment and the potential risks involved with these therapies. Information on expected outcomes from drug therapy that will aid in monitoring patients receiving treatment for SLE is provided.     

Late-onset systemic lupus erythematosus: epidemiology, diagnosis and treatment

Systemic lupus erythematosus (SLE) is usually described as a disease that most often strikes reproductive-age women. However, the onset of SLE beyond the age of 50 years is reported to occur in 3-18% of patients. This later age at onset has a strong modifying effect on the clinical presentation, disease course, response to treatment and prognosis of SLE. In comparison with younger patients, patients with late-onset SLE often have delayed diagnosis and less common occurrence of severe manifestations. For instance, literature data suggest that pulmonary involvement and serositis are more frequent in late-onset SLE, whereas malar rash, photosensitivity, arthritis and nephropathy occur less commonly. Furthermore, some distinct aspects of late-onset SLE may be influenced by the association with Sj?gren's syndrome, which is more frequent in the elderly. Not only clinical features but also serological manifestations of SLE change with aging. In comparison with early-onset SLE patients, older patients have a higher frequency of rheumatoid factor and of antinuclear antibody positivity, and a lower frequency of anti-ribonucleoprotein (anti-RNP) and anti-Sm antibody positivity. The major challenge for physicians managing patients with SLE is to treat the active phase without allowing the treatment itself to cause long-term damage. This is especially true in older and often polymedicated patients, in whom side effects of treatments are more frequent. Another important issue is that possible drug interactions should always be considered in the elderly. The management of the disease in these older patients depends on the type and severity of disease manifestations. The use of antimalarial agents such as hydroxychloroquine is an important aspect of SLE treatment, unless contraindicated. Other treatments mostly include NSAIDs, corticosteroids and immunosuppressive agents, depending on which organs are involved. Survival data may be used as an indirect way to assess the changes in the severity of SLE with aging, but the few studies available conclude that late-onset SLE is associated with poorer survival than early-onset SLE, which likely reflects the consequences of aging rather than true differences in survival. Importantly, the cause of death in late-onset SLE patients is usually not SLE itself, but rather the more frequent occurrence of infections, cardiovascular disorders, malignancies or drug-induced complications.     

系统性红斑狼疮并发抗磷脂综合征临床研究进展

抗磷脂综合征(the antiphospholipid syndrome,APS)是以持续存在抗磷脂抗体(antiphospholipid antibodies,aPL)为特征,以动静脉血栓形成和妊娠并发症为主要特征的一种自身免疫性疾病。APS常伴发其他疾病,最常继发于系统性红斑狼疮(systemic lupus erythematosus,SLE)。SLE的存在或缺失可能会改变临床或血清学APS表达。除了经典的表现外,SLE相关的APS的临床表现还多见于关节痛、关节炎、自身免疫性溶血性贫血、网状青斑、癫痫、肾小球血栓和心肌梗死。SLE和APS/APL病人的管理应包括血管风险因素精确分层。SLE合并APS/aPL预后较差,因此亟需新的治疗方法。未来的目标是通过早期诊断和最佳预防性治疗改善病人的预后。     

系统性红斑狼疮合并假性肠梗阻7例临床分析

目的分析系统性红斑狼疮(SLE)合并假性肠梗阻(IPO)的临床表现和实验室检查,提高对这种SLE类型的认识并总结治疗经验。方法回顾分析我院1990—2004年收治的7例SLE合并IPO。结果7例患者中男性1例,女性6例,平均年龄32.3岁;平均病程41个月;以IPO为首发症状4例,7例均在SLE病情活动期,合并腹腔积液4例,同时合并膀胱炎和尿路梗阻1例,7例抗核抗体均阳性,抗双链DNA抗体和抗SSA抗体阳性各4例,抗Sm抗体阳性2例,补体下降6例。用激素和环磷酰胺治疗后,7例均缓解,但其中1例治疗中出现败血症、激素减量后IPO复发而放弃治疗。结论IPO是临床少见但重要的一种SLE合并症;这种类型的SLE中IPO可为首发症状,而且常同时合并尿路梗阻和/或膀胱炎以及腹腔积液;多数患者对激素和免疫抑制剂治疗反应良好;重视多器官受累的表现以及自身抗体和补体的检测有助于及时作出正确的诊断和治疗。     

Lack of association between arylamine N-acetyltransferase 2 (NAT2) polymorphism and systemic lupus erythematosus

The slow arylamine -acetyltransferase 2 (NAT2) phenotype frequently has been assumed to be associated with an elevated risk to develop a lupus-like syndrome after administration of drugs such as procainamide or hydralazine. Moreover, there are conflicting data on the role of acetylator phenotype as a susceptibility factor for systemic lupus erythematosus (SLE). Because most investigations have previously been conducted with relatively small sample sizes, the present study was performed to clarify the possible association between genotypes and SLE among a large European cohort. In a case-control study, 209 patients with SLE (194 women, 15 men) were enrolled and matched by gender to 209 controls without clinical signs of inflammatory diseases. All SLE patients fulfilled at least four of the revised American College of Rheumatology classification criteria of SLE. was genotyped for seven known mutations by polymerase chain reaction/restriction fragment length polymorphism. The frequency of slow acetylation genotypes in SLE patients (59.8%) did not differ significantly from controls (56.5%). The adjusted odds ratio (OR) was 0.95 (95% confidence interval, 0.59-1.53). Further differentiation to gender, cigarette consumption, allergic disorders and specific SLE manifestations revealed an equal distribution of genotypes in all subgroups. We conclude that this large genotyping study in a Caucasian population demonstrated a lack of evidence for an association of the slow acetylator genotype with SLE.     

Warts and wart virus antibodies in patients with systemic lupus erythematosus.

Warts were found in 25 out of 56 patients with definite or probable systemic lupus erythematosus (SLE) but in only 19 out of 160 control patients. Warts were particularly prevalent in elderly patients with SLE. The corticosteroid and antimalarial drugs used to treat SLE did not influence the frequency of warts. Wart-virus antibodies were found significantly less often in patients with SLE than in controls: antibodies were detected in 23 out of 51 patients and in 40 out of 54 controls. Ihe findings suggest that some deficiency in the immune mechanisms of patients with SLE predisposes them to develop warts. There was an inverse correlation among the patients with SLE between the occurrence of warts and rheumatoid factor activity. This suggests that rheumatoid factor may interfere with resistance to warts.     

系统性红斑狼疮中枢神经系统病变诊断及治疗：附16例分析

本组６８例ＳＬＥ中１６例发生ＣＮＳ－ＳＬＥ，发生率为２３．５％，均为活动性重症ＳＬＥ，为多系统损害之一，发生于不同病程中，表现各异。腰穿检查对诊断很有帮助，主要是排除ＣＮＳ感染等。１３例用甲基强的松龙冲击治疗，１２例获完全缓解，近年３例用氨甲喋呤鞘内注射也获得缓解，效果满意。目前仍缓解存活１１例，已６个月至７年。