关键词: 系统性红斑狼疮, 假性肠梗阻, 治疗, 预后

Abstract:

ABSTRACT Objective: To observe and analyze the clinical manifestations and prognosis of systemic lupus erythematosus (SLE) complicated with intestinal pseudo-obstruction (IPO). Subjects and Methodology: From January 2004 to April 2014, 30 patients with SLE and IPO were enrolled to analysis the clinical manifestations, laboratory tests ,imaging characteristics, treatment and prognosis. Results: They were 26 females and 4 males, with mean age 26.1 ± 11.2years old. The median history of SLE was 27.5 months.The SLE-DAI score was 11.2 ± 7.4 when IPO occurred. 6 patients had identified induction factors (5 cases had unclean food, 1 case had respiratory tract infection). The most common manifestions of IPO were nausea and vomiting (76.6%), abdominal pain (66.7%), diarrhea (56.7%), bloating (30%).More than 75% patients showed intestinal obstruction in KUB and abdominal CT. 7 patients with hydronephrosis and ˆhydroureters concomitantly. Most cases had anemia(96.7%). 6 patients had thrombocytopenia and 8 patients had leukopenia. The direct coomb’s tests were positive in 4 cases. All patients had hypocomplementemia, with positive autoantidodies of ds_NDA (51.7%), anticardiolipin antibody (30.4%), lupus anticoagulant (43.8%) and anti-C1q antibody (47.4%). 29 patients were treated with aggressive immunosuppressive therapy, 10 patients received methylprednisolone plus (0.75～3g), 11 patients received gamma immunoglobulin therapy (15～100g). 29 patients were improved after therapy. The median remission time of IPO was 12d (8～19d). There was 24 patients follow-up 1to 60 months，2 died of complications，5 patients had relapse of IPO，4 cases entered ESRD. Patients had stable condition of lupus. Conclusion: SLE complicated with IPO is relatively rare in clinical. The manifestation is diversity and easily missed diagnose or misdiagnosis. Eearly diagnosis and timely immunosuppressive therapy could improve the prognosis.

Key words: systemic lupus erythematosus, intestinal pseudo-obstruction, immunosuppressive therapy, prognosis