儿童与成人系统性红斑狼疮的临床特点分析

Clinical Characteristics of Systemic Lupus Erythematosus in Children and Adults

摘要: 目的：探讨儿童与成人系统性红斑狼疮(systemic lupus erythematosus, SLE)临床表现及实验室指标的差异。方法：收集2013年4月~2017年6月在青岛大学附属医院首诊为系统性红斑狼疮患者，根据起病年龄分为儿童组(≤14岁)和成人组(>15岁)，分别进行组间临床表现、实验室指标、受累系统数量、SLEDAI (systemic lupus erythematosus disease activity index, SLEDAI)评分的比较。结果：共纳入108例SLE患者，成人组67例，儿童组41例。儿童组与成人组相比，颜面皮疹(68.3%/37.3%)、肌炎(14.6%/3.0%)、消化系统受累(36.6%/9.0%)、精神神经系统症状(29.2%/9.0%)、合并感染(65.9%/44.8%)的发生率差异有统计学差异(P < 0.05)。儿童组受累器官更多(t = 2.27)，SLEDAI评分更高(t = 2.03)，成人组与儿童组相比，呼吸系统受累率(56.7%/14.1%)差异有统计学意义(P < 0.05)。结论：成人与儿童SLE存在相似之处，但儿童SLE受累系统更多，临床表现更重。

Abstract: Objective: To explore the difference of clinical manifestations and laboratory data between children and adults with systemic lupus erythematosus (SLE). Methods: Collected the clinical information of patients with systemic lupus erythematosus who were first diagnosed in the Affiliated Hospital of Qingdao University from April 2013 to June 2017. The patients were divided into children group (≤14 years old) and adults group (>15 years old) according to the onset age. The clinical manifestations, laboratory data, number of affected systems and SLEDAI (systemic lupus ery-thematosus disease activity index) scores were compared between groups. Results: A total of 108 SLE patients were enrolled, including 67 adults and 41 children. Compared with the adults group, there was a statistically significant difference in facial rash (68.3%/37.3%), myositis (14.6%/3.0%), involved digestive system (36.6%/9.0%), neuropsychiatric symptoms (29.2%/9.0%) and the in-cidence of infection (65.9%/44.8%) (P < 0.05). The children group had more organs involved (t = 2.27), and the SLEDAI score was higher (t = 2.03), indicating that the child’s condition was more serious. Conclusion: There are similarities between adults and children with SLE, but children with SLE have more involved systems and more clinical manifestations.