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Expression of B-cell maturation antigen mRNA in Peripheral Blood Mononuclear Cells in Patients with Systemic Lupus Erythematosus

【摘要】 目的 检测B细胞成熟抗原（BCMA）mRNA在系统性红斑狼疮（SLE）患者外周血单个核细胞（PBMC）的表达水平，探讨BCMA在SLE发病中的意义。 方法 纳入2006年1-11月收治的36例SLE患者，同期17例健康志愿者作为对照组，采用半定量RT-PCR法检测外周血单个核细胞中BCMA mRNA的表达，并与SLE疾病活动指数（SLEDAI）进行相关性分析。 结果 SLE患者组BCMA mRNA表达水平（0.598±0.230）均明显高于正常对照组（0.411±0.309）（Plt;0.05）。SLE患者BCMA mRNA表达水平与SLEDAI评分无相关性（P=0.590）。 结论 SLE患者BCMA mRNA表达水平的增高，可能在SLE的发病机制中具有一定的作用。【Abstract】 Objective To detect the mRNA expression of B-cell maturation antigen (BCMA) in peripheral blood mononuclear cells (PBMC) in patients with systemic lupus erythematosus (SLE), and explore the role of BCMA in the pathogenesis of SLE. Methods From January 2006 to November 2006 the expression of BCMA mRNA in PBMC of 36 patients with SLE and 17 normal controls were measured by half-quantitative RT-PCR. The linear correlation between the expression of BCMA mRNA and SLE disease activity index (SLEDAI) was assessed. Results The level of BCMA mRNA (0.598±0.230) in PBMC significantly increased in SLE patients compared with that in the normal controls (0.411±0.309) (Plt;0.05). The expression of BCMA mRNA in SLE patients showed no correlation with SLEDAI score (P=0.590). Conclusion The results suggest that the expression of BCMA mRNA might play an important role in the pathogenesis of SLE.

系统性红斑狼疮视网膜病变三例

系统性红斑狼疮并发眼眶蜂窝织炎及远达性视网膜病变1例

人工全髋关节置换术治疗系统性红斑狼疮继发股骨头缺血性坏死五例

目的 总结人工全髋关节置换术（total hip arthroplasty，THA）治疗系统性红斑狼疮继发股骨头缺血性坏死（avascular necrosis of the femoral head，ANFH）患者的手术注意事项及围手术期处理。 方法 2007 年3 月－2009 年4 月，对5 例系统性红斑狼疮继发ANFH 患者症状严重侧行THA 治疗。男1 例，女4 例；年龄46 ～ 58 岁。系统性红斑狼疮病程4 ～ 24 年，手术时均处于红斑狼疮静止期。双侧ANFH 根据Ficat 分期均为Ⅳ期，病程2 ～ 12 年。术前Har ris 评分为（30.8 ± 5.4）分。 结果 5 例均顺利完成手术，围手术期输血量为1 200 ～ 2 200 mL。术后出现切口皮肤变态反应性炎症、血肿形成、浅部感染、切口窦道形成各1 例，均经对症处理后愈合；1 例切口Ⅰ期愈合。3 例术后出现反复发热，经对症处理后症状消退。术后患者均获随访，随访时间6 ～ 30 个月，平均14.4 个月。髋关节术前症状均显著缓解。术后Harris 评分为（86.5 ± 3.8）分，与术前比较差异有统计学意义（P lt; 0.001）。 结论 系统性红斑狼疮继发ANFH 患者行THA 术后并发症发生率较高，应注意准确掌握手术适应证，加强围手术期护理，以获得较好疗效。

Clinical analysis of retinal vein occlusion caused by systemic lupus erythematosus

Objective To investigate the clinical characteristics of retinalve in occlusion caused by systemic lupus erythematosus (SLE).Methods Visual acuities, fundus examination, antinuclear antibody (ANA), anti-double-stranded DNA（anti-dsDNA）, complement 3 (C3), complement 4 (C4) and erythrocyte sedimentation rate (ESR) were detected in 9 patients (12 eyes) with retinal vein occlusions caused by SLE. Fundus fluorescein angiography (FFA) was performed on 3 patients. Patients with other ocular or general lesions were analyzed.Results Central re tinal vein occlusion (CRVO) in 6 patients (8 eyes) and branch retinal vein occlusion (BRVO) in 3 (4 eyes) were found. The results of FFA showed that 5 eyes of 3 patients had extensive leakage of retinal vein and capillary. Four contralateral eyes of 6 patients with unilateral retinal vein occlusion had SLE fundus alte rations such as cotto-wool spot and retinal hemorrhage. Four patients had xerotic keratitis or ulcerative blepharitis and 8 had general lesions. Positive ANA and anti-dsDNA, and ESR gt;50 mm/h were detected in all the patients. Decreasing C3 in 6 patients and C4in 5 were found. Conclusions SLE is one of the general conditions causing retinal vein occlusion. Visual acuity and barrier of retinal vein and capillary are damaged seriously in patients with retinal vein occlusion caused by SLE, which may be accompanied with other ocular or general lesions. It is suggested that retinal vein occlusion is relative with SLE activity. (Chin J Ocul Fundus Dis，2003，19：201-268)

混合性转移性眼内炎一例

Spontaneous pneumothorax secondary to acute lupus pneumonitis: one case report and literature review

Objective To investigate the clinical characteristics of spontaneous pneumothorax secondary to systemic lupus erythematosus (SLE). Methods A case of spontaneous pneumothorax secondary to SLE was reported and related literatures were reviewed. Results A female patient, 26 years old, complaining of repeated fever for 3 months, chest tightness and shortness of breath more than 10 days, was hospitalized in December 2016. After admission, the patient was diagnosed as acute lupus pneumonia and received glucocorticoid, cyclophosphamide and plasma exchange therapy. Sudden right chest pain happened during hospitalization. Bedside chest CT showed right pneumothorax. After closed thoracic drainage, the syndrome of the patient was improved. A total of 14 patients were reviewd but 2 patients were excluded because of incomplete data. The left patients included 9 females and 3 males. The mean age was (28.0±11.9) years. Clinical manifestations of spontaneous pneumothorax secondary to SLE were sudden chest tightness and shortness of breath accompanied by subpleural lung cavity and vesicular changes. The majority of patients could be cured with drainage. Conclusions Pneumothorax secondary to SLE is rare which is associated with the rupture of cavity and cyst in pulmonary secondary to SLE. Majority of patients with pneumothorax could be cured after closed thoracic drainage.

系统性红斑狼疮伴发急腹症的护理

目的 总结系统性红斑狼疮（systemic lupus erythematosus, SLE）伴发急腹症(acute abdomen, AA)的临床特点与护理体会。 方法 对2004年1月-2009年1月收治的25例SLE伴发AA的临床资料与护理进行回顾性分析。 结果 AA是狼疮活跃的表现,加强其护理的同时不能忽略SLE的护理，重视健康教育。 结论 AA与SLE合并时病情危重，治疗护理有一定的特殊性，应引起护理人员关注。

红斑狼疮伴视网膜中央动脉阻塞一例

系统性红斑狼疮继发纯红细胞再生障碍一例

【摘要】　目的　提高对系统性红斑狼疮继发纯红细胞再生障碍（pure red cell aplasia，PRCA）的诊断和治疗认识。　方法　报道系统性红斑狼疮继发PRCA病例1例，观察患者对甲泼尼龙联合环孢素治疗的疗效。　结果　使用甲泼尼龙联合环孢素治疗后，系统性红斑狼疮继发PRCA患者血红蛋白恢复良好。　结论　大多数系统性红斑狼疮继发PRCA患者对糖皮质激素和免疫抑制剂联合治疗反应良好。