系统性红斑狼疮并发结核病39例临床分析
Clinic analysis of 39 cases of tuberculosis in patients with systemic lupus erythematosus
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摘要: 目的:了解系统性红斑狼疮(SLE)并发结核病患者的临床特点,探讨SLE并发结核病的诊断与治疗方法。方法:对39例SLE合并结核病患者的临床表现、实验室检查、病原学检查、病理结果、治疗与转归及糖皮质激素、免疫抑制剂的使用等一般情况进行分析。结果:39例患者中结核病类型为肺结核18例,肺外结核19例,肺结核合并肺外结核2例。SLE并发结核病患者发热39例,乏力37例,盗汗25例,咳嗽20例。患者均使用正规抗结核治疗,疗程9个月至1.5年。3例病死,余结核病情趋于痊愈。结论:SLE合并结核病患者的临床表现复杂多样,与单纯结核病和典型SLE的表现有所不同,诊断需排除其他病原微生物感染。治疗需兼顾基础病和结核病,早期诊断及规范化抗结核治疗是改善预后的重要手段。Abstract: Objective: To investigate the clinic characteristics,diagnosis and treatment of tuberculosis in patients with systemic lupus erythematosus(SLE).Methods: The data of 39 SLE patients with tuberculosis were analyzed retrospectively including the clinic manifestations,imaging data,laboratory examination results,diagnosis and treatment conditions.Results: In 39 SLE patients with tuberculosis,pulmonary tuberculosis were happened in 18 cases,extrapulmonary tuberculosis in 19 cases,pulmonary tuberculosis complicated with extrapulmonary tuberculosis in 2 cases.Tuberculosis in SLE patients with complex and diverse clinical manifestations such as fever was occurred in 39 cases,lack of power in 37 patients,night sweats in 25 cases,cough in 20 cases.All patients were using anti-tuberculosis treatment after diagnosis,the treatment course was 9 months to 1.5 years.Three cases was dead,the remaining patients tended to cure by the standardized treatment of tuberculosis disease.Conclusions: Tuberculosis in patients with SLE has complex and varied clinic symptoms,it's different from simple tuberculosis and typical SLE.It is needed to notice if there was combined with other pathogens infection.Treatment needs to give consideration to the basic disease and tuberculosis.Early diagnosis and standardization of anti-tuberculosis are the important means which can improve the prognosis.
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Key words:
- lupus erythematosus,systemic /
- tuberculosis /
- clinical manifestation /
- treatment
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