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作者对已确诊的140例 SLE 患者中之12例伴有肺部病变者进行了随访,其中3人发生了大量的肺出血,2人在短期内死亡。SLE 并发肺部病变的发生率可高达50～70%。常见的并发症是胸膜炎、间质性肺炎(可为游走性)及其他非特异性病变,如感染及肺泡壁损伤伴间质性水肿、炎症及增厚。也有报道说可有血栓及透明膜的形成,而广泛的肺出血是罕见的并发症。有肺出血的病人,临床上可有发烧、咳嗽、气短、呼吸困难。体检时可听到干湿罗音,胸部 X 片可见双侧间质性浸润(例1),肺水肿(例2)及弥漫性、间质性浸润伴有实变及空洞(例3)。临床症状常是非特异性的,所以对肺出血的诊断帮助不大。
The authors followed up 12 of 140 confirmed SLE patients with pulmonary lesions, 3 of whom developed massive pulmonary hemorrhage and 2 died within a short period of time. The incidence of SLE concurrent pulmonary disease can be as high as 50 to 70%. Common complications are pleurisy, interstitial pneumonia (which can be migratory), and other nonspecific lesions such as infection and alveolar wall injury with interstitial edema, inflammation, and thickening. It has also been reported that thrombus and hyaline membrane may be formed, and extensive pulmonary hemorrhage is a rare complication. Patients with pulmonary hemorrhage, the clinical may have a fever, cough, shortness of breath, difficulty breathing. Dry and wet rales can be heard on examination, with bilateral interstitial infiltrates (case 1), pulmonary edema (case 2), diffuse interstitial infiltration with consolidation and emptiness in chest X (case 3). Clinical symptoms are often non-specific, so the diagnosis of pulmonary bleeding is not helpful.