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狼疮性视网膜病变在系统性红斑狼疮中的作用。

Role of lupus retinopathy in systemic lupus erythematosus.

作者信息

Kharel Sitaula Ranju, Shah Dev Narayan, Singh Divya

机构信息

Department of Ophthalmology, B. P. Koirala Lions Centre for Ophthalmic Studies, Tribhuvan University Institute of Medicine, PO Box-5889, Maharajgunj, Kathmandu, Nepal.

Department of Internal Medicine, Tribhuvan University Teaching Hospital, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.

出版信息

J Ophthalmic Inflamm Infect. 2016 Dec;6(1):15. doi: 10.1186/s12348-016-0081-4. Epub 2016 May 12.

Abstract

BACKGROUND

Lupus retinopathy is one of the most common vision-threatening complications of systemic lupus erythematosus. The presence of lupus retinopathy is an accurate guide to the presence of active systemic disease activity.

RESULTS

A prospective study was conducted looking at 91 established cases of systemic lupus erythematosus to evaluate lupus retinopathy. The patients were divided into two groups according to the presence or absence of lupus retinopathy, and a comparison of clinical and laboratory findings between two groups was done. Among 91 SLE patients, 5 were male and 86 were female; of which, 85 (93.4 %) were outpatients and 6 (6.6 %) were inpatients. Lupus retinopathy was found in 13 eyes of 11 cases out of 91 cases (12.1 %). Among these 13 eyes with lupus retinopathy, 61.5 % had mild type of lupus retinopathy, 15.4 % had moderate type, and 23.1 % had severe lupus retinopathy. The mean age of the cases at ophthalmological examination with and without retinopathy was 30.4 and 31.9 years, respectively. The mean serum creatinine level was 190.4 μmol/l which was higher than in the patients without retinopathy (96.2 μmol/l). The mean ESR in patients with retinopathy was higher than without retinopathy (34.2 vs. 32). Similarly, the mean platelet count in SLE patients with retinopathy was 154,245/μl and in SLE patients without retinopathy was 135,828/μl.

CONCLUSIONS

Retinal lesions in SLE patients are of critical importance, both visually and prognostically.

摘要

背景

狼疮性视网膜病变是系统性红斑狼疮最常见的威胁视力的并发症之一。狼疮性视网膜病变的存在是系统性疾病活动的准确指标。

结果

进行了一项前瞻性研究,观察91例确诊的系统性红斑狼疮患者以评估狼疮性视网膜病变。根据有无狼疮性视网膜病变将患者分为两组,并对两组的临床和实验室检查结果进行比较。91例系统性红斑狼疮患者中,男性5例,女性86例;其中,85例(93.4%)为门诊患者,6例(6.6%)为住院患者。91例患者中有11例(12.1%)的13只眼睛发现有狼疮性视网膜病变。在这13只患有狼疮性视网膜病变的眼睛中,61.5%为轻度狼疮性视网膜病变,15.4%为中度,23.1%为重度狼疮性视网膜病变。有视网膜病变和无视网膜病变的患者眼科检查时的平均年龄分别为30.4岁和31.9岁。血清肌酐平均水平为190.4μmol/l,高于无视网膜病变的患者(96.2μmol/l)。有视网膜病变的患者平均血沉高于无视网膜病变的患者(34.2对32)。同样,有视网膜病变的系统性红斑狼疮患者平均血小板计数为154,245/μl,无视网膜病变的系统性红斑狼疮患者平均血小板计数为135,828/μl。

结论

系统性红斑狼疮患者的视网膜病变在视力和预后方面都至关重要。

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