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目的探讨系统性红斑狼疮(SLE)合并肾盂输尿管积水的临床特点。方法对17例SLE合并肾盂输尿管积水(除外结核、结石及横贯性脊髓炎所致肾盂输尿管积水)病人的临床资料进行回顾性分析,并从临床特点、实验室检查和治疗及预后等方面进行总结。结果17例患者发病到检查发现肾盂输尿管积水的时间平均为25.8个月。4例肾盂输尿管积水治疗后复查B超积水情况明显改善,2例手术病人积水情况亦改善;4例无改善;6例临床情况改善,但无影像方面资料;1例死亡。合并假性肠梗阻13例(76.5%)。结论SLE合并肾盂输尿管积水并不罕见,主要发生于成人,但亦可发生于儿童;SLE合并肾盂输尿管积水的患者易出现消化道的症状特别是合并慢性假性肠梗阻,两者之间有明显相关性。通常对激素治疗有一定反应,但应早期发现,积极治疗。对发生早期梗阻性肾病肾功能不全者手术治疗仍有逆转肾功能的希望。
Objective To investigate the clinical features of systemic lupus erythematosus (SLE) combined with pelvic hydronephrosis. Methods The clinical data of 17 patients with SLE combined with ureteropelvic hydronephrosis (ureter hydronephrosis caused by tuberculosis, stones and transverse myelitis) were analyzed retrospectively. From the aspects of clinical features, laboratory examination and treatment and prognosis Giving a summary. Results The onset of pyeloureteral hydronephrosis was found in 17 patients with an average of 25.8 months. 4 cases of ureteropelvic hydronephrosis after re-examination of B-hydrocephalus was significantly improved, 2 cases of patients with hydrocephalus also improved; 4 cases without improvement; 6 cases of clinical improvement, but no imaging information; 1 case of death. Pseudo intestinal obstruction in 13 cases (76.5%). Conclusions SLE with hydronephrosis is not uncommon and occurs mainly in adults but can also occur in children. Patients with SLE with hydronephrosis tend to have digestive symptoms, especially with chronic pseudo-intestinal obstruction, There is a clear correlation. Usually a certain response to hormone therapy, but should be found early, active treatment. Surgical treatment of renal failure in patients with early obstructive nephropathy still hope to reverse renal function.