目的 回顾性研究老年系统性红斑狼疮(SLE)患者合并感染的危险因素。 方法 选取1995年1月-2009年12月间在四川大学华西医院确诊为SLE,起病年龄为50周岁以上的158例患者,收集性别、临床表现、疾病活动度、实验室检查指标、合并症以及并发症等进行单因素分析或多因素非条件logistic回归分析。 结果 所纳入的158例患者中,合并感染53例(占33.5%),采用单因素分析显示疾病活动性(P=0.001)、低蛋白血症(P=0.030)、糖尿病(P=0.003)、肺间质病变(P=0.000)与老年SLE患者感染发生有关。经logistic回归分析显示,疾病活动性(OR=7.533,P=0.000)、肺间质病变(OR=19.762,P=0.000)、糖尿病(OR=6.862,P=0.025)是老年SLE患者感染发生的危险因素。 结论 积极控制老年SLE的疾病活动度,减少危险因素的发生是控制老年SLE患者并发感染的有效手段。
ObjectiveTo investigate the clinical characteristics of pancreatitis, panniculitis, and polyarthritis syndrome (PPP syndrome). MethodsA patient with PPP syndrome in July 2013 was reported. The clinical features of 33 cases of PPP syndrome at home and abroad were reviewed. ResultsOur patient with panniculitis and arthritis as the first manifestation had few abdominal symptoms despite high serum levels of pancreatic enzymes. In the 34 PPP cases, 70.6% (24/34) had absent or mild abdominal symptoms, easily leading to misdiagnosis. Multi-joint involvement was more common, and in almost 1/3 of the patients, joint symptoms with poor NSAIDs and/or hormonal responses predated the identification of pancreatic disease. Panniculitis biopsy found characteristic "ghost cells". Ten patients died of complications of pancreatic disease (including 2 cases of cancer), and the mortality rate was as high as 29.4% (10/34). ConclusionPPP syndrome with mild abdominal symptoms and high mortality should be taken for the treatment of pancreatic disease, to prevent misdiagnosis and mistreatment.