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目的探讨系统性红斑狼疮(SLE)合并慢性假性肠梗阻(CIPO)的临床特点,以提高对SLE的认识。方法对11例SLE合并假性肠梗阻患者的临床资料进行回顾性分析,并从临床特点、实验室检查、治疗及预后等方面进行总结。结果7例患者以CIPO为首发症状。10例有尿路积水,4例抗SSA抗体双扩散法阳性,7例免疫印迹法阳性,阳性率较普通SLE高。11例患者均接受足量激素治疗,9例合并应用细胞毒性药物。除1例患者因对本病认识不足所致治疗延误死亡外,其他患者的症状都有缓解。1例极早期单侧输尿管积水经治疗后消失。对大多数患者肾盂、输尿管积水的情况缓解不明显,但进展亦慢。结论SLE合并CIPO者极易合并肾盂、输尿管积水,对SLE有胃肠道表现者应注意有无肾盂、输尿管积水和膀胱炎。本病对激素治疗反应尚可,应早期发现,积极治疗。应当重视SLE合并CIPO并发症,减少不必要的手术和有创的检查。
Objective To investigate the clinical features of systemic lupus erythematosus (SLE) complicated with chronic intestinal obstruction (CIPO) to improve the understanding of SLE. Methods The clinical data of 11 patients with SLE combined with intestinal pseudo - obstruction were retrospectively analyzed. The clinical characteristics, laboratory examination, treatment and prognosis were summarized. Results Seven patients had CIPO as their first symptom. 10 cases had urinary tract hydrops, 4 cases were positive for anti-SSA antibody double diffusion method, 7 cases were positive for immunoblot, the positive rate was higher than that of common SLE. Eleven patients received adequate hormone therapy, and nine patients were treated with cytotoxic drugs. All patients except one died of treatment delay due to lack of knowledge of the disease. All patients had symptoms relieved. One case of very early unilateral ureteral hydronephrosis disappeared after treatment. Most patients with renal pelvis, ureteral hydrops did not ease the situation, but progress is slow. Conclusions SLE combined with the CIPO who easily merged the renal pelvis, ureter hydronephrosis, gastrointestinal manifestations of SLE should pay attention to whether there is renal pelvis, ureteral hydronephrosis and cystitis. The disease response to hormone therapy is acceptable, should be found early, active treatment. Emphasis should be placed on SLE combined with CIPO complications, reducing unnecessary surgeries and invasive tests.