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系统性红斑狼疮合并急性肺血栓栓塞症一例

系统性红斑狼疮伴发急腹症的护理

目的 总结系统性红斑狼疮（systemic lupus erythematosus, SLE）伴发急腹症(acute abdomen, AA)的临床特点与护理体会。 方法 对2004年1月-2009年1月收治的25例SLE伴发AA的临床资料与护理进行回顾性分析。 结果 AA是狼疮活跃的表现,加强其护理的同时不能忽略SLE的护理，重视健康教育。 结论 AA与SLE合并时病情危重，治疗护理有一定的特殊性，应引起护理人员关注。

Relevances of serum prolactin level to clinical symptoms and disease activity of systemic lupus erythematosis

Objective To explore the relevances of serum prolactin level to clinical symptoms and disease activities of systemic lupus erythematosis (SLE). Methods From December 2008 to December 2014, 63 female patients who met the American Rheumatism Society diagnostic criteria of SLE in the First People’s Hospital of Chengdu were collected as the SLE group, and other 20 healthy females were collected as the control group. The serum prolactin level was determined by immunofluorescence, and the disease activity of SLE was assessed by SLE Disease Activity Index (SLEDAI). The relevances of serum prolactin level to clinical symptoms and disease activity of SLE patients were analyzed. Results The mean serum prolactin level was (22.35±14.86) ng/mL in the SLE group and (15.30±8.54) ng/mL in the control group, respectively; the difference was statistically significant (P<0.05). In the 63 SLE patients, 15 (23.8%) had higher serum prolactin level compared with the normal ones. According to the SLEDAI score, the SLE patients were divided into stable group (25 patients), mild activity group (21 patients), moderate activity group (10 patients), and severe activity group (7 patients); and their serum prolactin levels were (20.43±11.23), (22.50±13.54), (27.97±21.20), and (33.91±18.18) ng/mL, respectively; the differences were not statistically significant (P>0.05). There were statistically significant differences (P<0.05) between the SLE patients with hyperprolactinemia and the ones with normal serum prolactin level in a number of clinical symptoms such as serositis, kidney damage,hematological system damage, and hypocomplementemia, but the serum prolactin level was not significantly correlated with the SLEDAI (rs=0.217, P=0.088). Conclusions Less hyperprolactinemia is found in SLE patients. Serum prolactin level is correlated with multiple clinical symptoms and laboratory indexes but not related to disease activity in SLE patients.

Correlation between TNF-α Promoter–308A/G Polymorphism and Systemic Lupus Erythematosus in Chinese Populations: A Meta-analysis

Objective　To summarize results of the correlation of tumor necrosis factor-α (TNF-α) promoter –308A/G polymorphism with systemic lupus erythematosus (SLE) susceptibility in Chinese populations. Methods　We collected all the publications about the correlation between TNF-α promoter –308A/G polymorphism and SLE in Chinese populations by searching PubMed, EBSCO, CBM, CNKI and Wanfang Data before the date of March 20, 2010. Meta-analysis was performed for checking the difference between two groups about genotypes such as AA versus GG, GA versus GG, AA versus GG+GA, GA+AA versus GG, and A allele versus G allele. Results　A total of 8 studies involving 731 SLE patients and 901 healthy people were included. The meta-analysis of total populations showed that, there was no significant correlation between A allele and increased SLE risk (OR=1.42, 95%CI 0.97 to 2.09, P=0.07); the meta-analyses of populations in different regions showed there was no significant correlation of A allele and increased SLE risk in Chinese Taiwan populations (OR=1.04, 95%CI 0.77 to 1.40, P=0.82). Moreover, there was no significant difference between SLE group and control group in the genotypes of AA versus GG, GA versus GG, AA versus GG+GA, and GA+AA versus GG.Conclusion　This meta-analysis dosen’t demonstrate the correlation between TNF-α promoter–308A/G polymorphism and SLE in Chinese populations.

系统性红斑狼疮尸检一例

目的 探讨系统性红斑狼疮的病变特点。 方法 对一例系统性红斑狼疮死者进行全面、系统的病理学解剖及组织学检查。 结果 本例可见系统性红斑狼疮的典型肾脏病变、心脏病变、脾脏病变，而较为少见的肺脏小动脉及肾小管病变亦在本例中发现。 结论 系统性红斑狼疮是一种累及多系统、临床表现多样的疾病，了解此疾病的典型病变有助于临床医生的诊断和治疗。

系统性红斑狼疮患者行二尖瓣成形术一例

系统性红斑狼疮并发眼眶蜂窝织炎及远达性视网膜病变1例

Expression of B-cell maturation antigen mRNA in Peripheral Blood Mononuclear Cells in Patients with Systemic Lupus Erythematosus

【摘要】 目的 检测B细胞成熟抗原（BCMA）mRNA在系统性红斑狼疮（SLE）患者外周血单个核细胞（PBMC）的表达水平，探讨BCMA在SLE发病中的意义。 方法 纳入2006年1-11月收治的36例SLE患者，同期17例健康志愿者作为对照组，采用半定量RT-PCR法检测外周血单个核细胞中BCMA mRNA的表达，并与SLE疾病活动指数（SLEDAI）进行相关性分析。 结果 SLE患者组BCMA mRNA表达水平（0.598±0.230）均明显高于正常对照组（0.411±0.309）（Plt;0.05）。SLE患者BCMA mRNA表达水平与SLEDAI评分无相关性（P=0.590）。 结论 SLE患者BCMA mRNA表达水平的增高，可能在SLE的发病机制中具有一定的作用。【Abstract】 Objective To detect the mRNA expression of B-cell maturation antigen (BCMA) in peripheral blood mononuclear cells (PBMC) in patients with systemic lupus erythematosus (SLE), and explore the role of BCMA in the pathogenesis of SLE. Methods From January 2006 to November 2006 the expression of BCMA mRNA in PBMC of 36 patients with SLE and 17 normal controls were measured by half-quantitative RT-PCR. The linear correlation between the expression of BCMA mRNA and SLE disease activity index (SLEDAI) was assessed. Results The level of BCMA mRNA (0.598±0.230) in PBMC significantly increased in SLE patients compared with that in the normal controls (0.411±0.309) (Plt;0.05). The expression of BCMA mRNA in SLE patients showed no correlation with SLEDAI score (P=0.590). Conclusion The results suggest that the expression of BCMA mRNA might play an important role in the pathogenesis of SLE.

系统性红斑狼疮患者使用免疫抑制剂后卵巢贮备功能的临床评估

目的研究抗苗勒管激素（AMH）与系统性红斑狼疮（SLE）女性患者使用免疫抑制剂的关系，评估SLE患者卵巢贮备功能。 方法选取2009年1月-2013年12月72例年龄在18～40岁，符合美国风湿病学会诊断标准的初诊SLE女性患者，使用酶联免疫吸附测定法对患者用药前后血清中AMH进行检测，选取同期20例同年龄段健康女性作为正常对照。比较使用环磷酰胺（CTX）患者（A组，n=41）与未使用CTX患者（B组，n=31）血清AMH的差异，了解AMH水平与CTX累积剂量及年龄之间的关系。 结果72例SLE患者使用免疫抑制剂后血清中AMH水平[（2.39±1.12）ng/mL]较使用前[（3.12±1.38）ng/mL]及正常对照组[（2.95±0.86）ng/mL]低，差异均有统计学意义（P＜0.05）。治疗后A组患者血清中AMH水平[（2.24±1.23）ng/mL]低于治疗前[（2.97±1.31）ng/mL]，且低于B组患者血清中AMH水平[（2.92±0.82）ng/mL]，差异有统计学意义（P＜0.05）；B组治疗前差异无统计学意义（P＞0.05）。AMH水平与使用CTX累积剂量及年龄呈负相关（P＜0.05）。 结论AMH可以作为评价SLE女性患者在使用CTX后造成卵巢损伤的一个指标。

系统性红斑狼疮合并肠穿孔的临床分析

目的探讨系统性红斑狼疮（SLE）引发肠穿孔的临床特点。 方法对2011年1月－2013年1月外科重症监护室收治的3例SLE引发肠穿孔病例，结合相关文献分析该类疾病的临床表现和治疗方法。 结果患者经积极治疗，病情逐渐稳定，均康复出院。 结论SLE合并肠穿孔临床上较少见，迷惑性强，容易误诊误治，未及时发现穿孔可引起严重后果。