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目的探讨老年系统性红斑狼疮(SLE)患者的临床表现、实验室指标、治疗情况及激素副作用。方法回顾性分析33例老年SLE患者的病例资料,并与同期收治的63例中青年SLE患者比较,分析其临床特点。结果与中青年组相比,老年组确诊所需时间较长(P<0.05);老年SLE面部红斑、脱发、尿蛋白阳性及补体C3下降、ESR及CRP升高、血白细胞及血小板减少比例较低(P<0.05);伴发浆膜炎、肺脏损害、高血压、骨质疏松、干燥综合征比例较高(P<0.05);ANA、抗ds-DNA抗体、抗Sm抗体、抗核小体抗体及抗核糖体P蛋白抗体阳性率在两组间差异无统计学意义(P>0.05);老年组接受间歇静脉滴注CTX治疗患者比例明显低于中青年组(P<0.05),激素副作用发生率较中青年组高(P<0.05)。结论老年SLE较少出现狼疮典型的临床表现及脏器损害,激素副作用发生率高。
Objective To investigate the clinical manifestations, laboratory parameters, treatment and hormone side effects in elderly patients with systemic lupus erythematosus (SLE). Methods A retrospective analysis of 33 cases of elderly patients with SLE, and with the same period were treated 63 cases of young and middle-aged SLE patients, analysis of its clinical features. Results Compared with the middle-aged group, the elderly group had a longer diagnosis time (P <0.05). The age-related erythema, alopecia, urinary protein positive and decreased C3 in elderly SLE patients were associated with elevated ESR and CRP, and the ratio of leukopenia and thrombocytopenia ANA, anti-dsDNA antibody, anti-Sm antibody, anti-nuclear small (P <0.05); associated with serositis, lung damage, hypertension, osteoporosis, Sjogren’s syndrome higher proportion (P> 0.05). The proportion of elderly patients receiving intermittent intravenous infusion of CTX was significantly lower than that of the young and middle-aged patients (P <0.05), and the positive rate of anti-ribosomal protein P antibody was not significantly different between the two groups The incidence of side effects was higher than that of middle-aged group (P <0.05). Conclusion The elderly patients with SLE less typical clinical manifestations and organ damage, high incidence of side effects of hormones.