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系统性红斑狼疮合并肝衰竭患者的临床分析。

Clinical analysis of patients with systemic lupus erythematosus complicated with liver failure.

机构信息

Integrated Traditional Chinese and Western Medicine Center, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.

Department of Infectious Diseases, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.

出版信息

Clin Rheumatol. 2023 Jun;42(6):1545-1553. doi: 10.1007/s10067-023-06524-9. Epub 2023 Feb 16.

Abstract

The objective of this study is to analyze and summarize the characteristics of the clinical data of patients with systemic lupus erythematosus (SLE) complicated with liver failure, and to improve the cognition of the disease. The clinical data of patients with SLE complicated with liver failure hospitalized in Beijing Youan Hospital from January 2015 to December 2021 were collected retrospectively, including general information and laboratory examination data, and the clinical characteristics of the patients were summarized and analyzed. Twenty-one SLE patients with liver failure were analyzed. The diagnosis of liver involvement was earlier in 3 cases than that of SLE, and later in 2 cases. Eight patients were diagnosed with SLE and autoimmune hepatitis at the same time. The medical history is between 1 month and 30 years. This was the first case report of SLE complicated with liver failure. We found that: (1) among the 21 patients, organ cysts (liver and kidney cysts) were more common and the proportion of cholecystolithiasis and cholecystitis was higher than that in previous studies, but the proportion of renal function damage and joint involvement was lower. (2) The inflammatory reaction was more obvious in SLE patients with acute liver failure. The degree of liver function injury in SLE patients with autoimmune hepatitis was less than that in patients with other liver diseases. (3) The use of glucocorticoid in SLE patients with liver failure was worthy of further discussion. Key Points • Patients with SLE complicated with liver failure have a lower proportion of renal impairment and joint involvement. • The study firstly reported SLE patients with liver failure. • Glucocorticoids in the treatment of SLE patients with liver failure are worthy of further discussion.

摘要

本研究旨在分析和总结系统性红斑狼疮(SLE)合并肝衰竭患者的临床资料特点,提高对该病的认识。回顾性收集 2015 年 1 月至 2021 年 12 月北京佑安医院收治的 21 例 SLE 合并肝衰竭患者的临床资料,包括一般资料、实验室检查等,总结分析患者的临床特点。21 例 SLE 合并肝衰竭患者中,3 例肝损害先于 SLE 诊断,2 例后于 SLE 诊断;8 例同时诊断为 SLE 和自身免疫性肝炎;病程 1 个月至 30 年。其中首次报道 SLE 合并肝衰竭。发现:(1)21 例患者中,器官囊肿(肝、肾囊肿)更常见,胆囊结石和胆囊炎的比例高于既往报道,而肾功能损害和关节受累的比例较低;(2)急性肝衰竭的 SLE 患者炎症反应更明显,自身免疫性肝炎所致的 SLE 患者肝功能损伤程度轻于其他肝病所致的 SLE 患者;(3)SLE 合并肝衰竭患者应用糖皮质激素治疗值得进一步探讨。

关键点

•SLE 合并肝衰竭患者的肾功能损害和关节受累比例较低。

•本研究首次报道了 SLE 合并肝衰竭。

•SLE 合并肝衰竭患者应用糖皮质激素治疗值得进一步探讨。

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