论文部分内容阅读
目的分析以严重弥漫性肺泡出血(DAH)为突出表现的重症系统性红斑狼疮(SLE)的临床特点,以期提高对危重病例的诊治水平。方法报道1例SLE以DAH为突出表现,并有多系统损害,合并甲状腺激素水平降低,分析诊治经过。结果该患者DAH主要表现为呼吸衰竭、咯血、贫血进行性加重,影像学显示双肺弥漫性浸润影。给予免疫抑制治疗和机械通气辅助呼吸,积极防治并发症,成功救治。结论 DAH是SLE少见而致命的并发症,早期强化免疫抑制治疗和积极的机械通气等支持治疗有望改善预后。重症狼疮可伴发甲状腺功能异常,甲状腺素水平与狼疮活动密切相关。
Objective To analyze the clinical features of severe systemic lupus erythematosus (SLE) with severe diffuse alveolar hemorrhage (DAH) in order to improve the diagnosis and treatment of critical cases. Methods One case of SLE with DAH as a prominent manifestation, and more systematic damage, combined with thyroid hormone levels decreased, the analysis of treatment after. Results The main manifestations of DAH in this patient were respiratory failure, hemoptysis and anemia. The imaging showed diffuse infiltration of lungs. Given immunosuppressive therapy and mechanical ventilation assisted breathing, active prevention and treatment of complications, successful treatment. Conclusions DAH is a rare and fatal complication of SLE. Supportive treatment such as early intensive immunosuppressive therapy and active mechanical ventilation may improve the prognosis. Severe lupus may be associated with thyroid dysfunction, thyroid hormone levels and lupus activity are closely related.