系统性红斑狼疮视网膜病变的临床特点分析

摘要

目的：总结临床系统性红斑狼疮(SLE)合并视网膜病变患者的临床特点,以提升对该病症的认识。方法回顾性分析30例SLE合并视网膜病变患者的临床资料。结果30例患者均伴有不同程度的身体其他器官受累情况,以累及皮肤者比例最高,占70.00%,其次是肾脏病变与中枢神经系统损伤,分别占46.67%、43.33%；所有患者均为狼疮活动期,并以中度活动者最多,占70.00%,且经相关实验室检查,所有患者的抗核抗体(ANA)均显示为阳性,且其中,18例(60.00%)患者的抗双链DNA显示为阳性,10例(33.33%)患者显示为抗心磷脂抗体阳性；30例患者共累及44只眼,28例患者均伴有不同程度的视力降低,且有7例患者因视力降低来院就诊,22只眼视力在0.1~0.5间,14只眼视力在0.5以上,其余8只眼视力均在0.1以下；而关于患者眼部病变,30只眼表现为以视网膜棉绒斑、视网膜出血与视网膜静脉阻塞最多；所有患者均给予对症治疗,其中23例患者的眼部症状均得到了相应的改善,7例患者的眼部症状无明显改善。结论SLE合并视网膜病变将对患者的视力造成极大影响,并累及到多器官,病情发展较快,特别是活动期的SLE患者必须接受常规眼底检查,以实现对病情的有效诊断,进而采取相应的治疗办法。%ObjectiveTo summarize clinical characteristics of systemic lupus erythematosus (SLE) complicated with retinopathy, in order to improve understanding of the disease.MethodsClinical data of 30 SLE complicated with retinopathy patients were retrospectively analyzed.ResultsAll the 30 cases had involved body organs with different degree. Patients with involved skin accounted for 70.00%, as the largest proportion. Patients with involved nephropathy and central lesion accounted for 46.67% and 43.33%. All patients were at activity stage, and most of them were in moderate activity, accounting for 70.00%. All patients had positive antinuclear antibodies (ANA), with 18 cases (60.00%) of positive anti-double chains DNA and 10 cases (33.33%) of positive anticardiolipin antibody. There were totally 44 involved eyes in the 30 patients, and 28 cases among them had decreased eyesight with different degree. There were 7 cases of them going to hospital due to decreased eyesight. There were 22 eyes with eyesight as 0.1~0.5, 14 eyes with eyesight over 0.5, and 8 eyes under 0.1. 30 eyes had eye disease of retinal lint spot, retinal hemorrhage and retinal vein occlusion. Symptomatic treatment was given for the patients, and 23 cases of them had improved eye symptoms, while 7 cases were not obviously improved. ConclusionSLE complicated with retinopathy provides huge influence on patients’ eyesight, along with multiple involved organs and quick progress. Patients in activity stage of SLE must receive conventional fundus examination, in order to provide effective diagnosis and apply corresponding treatment methods.