CAJ | 학술논문

目的了解伴雷诺现象(RP)的系统性红斑狼疮(SLE)患者的临床特征。方法对近4年在我院住院的42例伴RP的SLE患者进行临床分析，并与116例无RP的SLE患者进行对照。结果与无RP组相比，有RP组出现脱发、肌炎/肌病、心脏受累和肺动脉高压的几率明显增高(分别为56.90％～83.33％，9.48％～23.81％，29.3l％～59.52％，1.72％～21.43％，P<0.05或0.01)。γ-球蛋白升高，抗核抗体、抗RNP及抗Sm抗体的阳性率也明显增高(分别为50.52％～73.68％，68.47％～87.80％，24.04％～70.00％，7.69％～35.00％，P<0.05或0.01)。而两组患者在肾炎、神经系统受累及血液系统受累的发生率差异无显著性(P均>0.05)。对125例患者进行了平均2.15年的随访，其中包括全部的11例肺动脉高压患者，死亡3例，其中1例死于肺动脉高压并发右心衰竭(有RP组)。结论SLE患者出现雷诺现象提示较易发生肺动脉高压、心脏受累和免疫学异常，对伴雷诺现象的SLE患者应注意其心肺状态，以便早期诊断和治疗。
목적료해반뢰낙현상(RP)적계통성홍반랑창(SLE)환자적림상특정。방법대근4년재아원주원적42례반RP적SLE환자진행림상분석，병여116례무RP적SLE환자진행대조。결과여무RP조상비，유RP조출현탈발、기염/기병、심장수루화폐동맥고압적궤솔명현증고(분별위56.90％～83.33％，9.48％～23.81％，29.3l％～59.52％，1.72％～21.43％，P<0.05혹0.01)。γ-구단백승고，항핵항체、항RNP급항Sm항체적양성솔야명현증고(분별위50.52％～73.68％，68.47％～87.80％，24.04％～70.00％，7.69％～35.00％，P<0.05혹0.01)。이량조환자재신염、신경계통수루급혈액계통수루적발생솔차이무현저성(P균>0.05)。대125례환자진행료평균2.15년적수방，기중포괄전부적11례폐동맥고압환자，사망3례，기중1례사우폐동맥고압병발우심쇠갈(유RP조)。결론SLE환자출현뢰낙현상제시교역발생폐동맥고압、심장수루화면역학이상，대반뢰낙현상적SLE환자응주의기심폐상태，이편조기진단화치료。
Objective To study the clinical features of the patients with systemic lupus erythematosus (SLE) with Raynaud＇s phenomenon. Methods The clinical manifestations and laboratory findings of 42 SLE patients with Raynaud's phenomenon were analyzed and compared with those of 116 SLE patients without Raynaud's phenomenon. Results As compared with SLE patients without Raynaud＇s phenomenon, the SLE patients with Raynaud＇s phenomenon were more likely to have myalgia/myopathy(9.48% vs 23.81%,P<0.05), alopecia(56.90% vs 83.33% ,P<0.01), pulmonary hypertension(1.72% vs 21.43%,P<0.01),cardiac involvement(29.31% vs 59.52%,P<0.01), elevated serum level of gamma-globulin (50.52% vs 73.68%,P<0.05), positive antinuclear antibodies(68.47% vs 87.80%,P<0.05), positive anti-RNP antibodies (24.04% vs 70.00%,P<0.01) and positive anti-Sm antibodies(7.69% vs 35.00%,P<0.05).There were no significant differences in nephritis, neuropsychiatric and hematologic alterations between two groups. Among the 11 SLE patients with pulmonary hypertension, 3 patients died and 1 of them died of secondary heart failure, during 26-month follow - up. Conclusions The Raynaud＇s phenomenon in SLE patients seems susceptible to pulmonary hypertension, cardiac involvement and immunologic abnormalities. The function of heart and lung and pulmonary hypertension should be paid attention to in these cases.