Clinical Analysis Of 24 Cases Of Systemic Lupus Erythematosus Complicated With Mesenteric Vasculitis

Objective By analyzing the clinical features of mesenteric vasculitis of lupus,this paper was aimed to provide referential basis for diagnosis,differential diagnosis,treatment and prognosis of LMV patients.Methods From December 2010 to January 2017,54 patients with SLE were analyzed retrospectively.According to the criteria of mesenteric vasculitis,they were divided into two groups: the group with mesenteric vasculitis and the group without mesenteric vasculitis.The clinical data of the two groups were compared and analyzed by SPSS 22.0 Software.Results 1.There was no significant difference in the symptoms of rash,fever and arthralgia between the two groups(p>0.05),but there was significant difference in abdominal pain,nausea / vomiting,abdominal distension and diarrhea between the two groups(p<0.01).2.Renal involvement was the most common in 24 patients with LMV.There was significant difference between the two groups in liver involvement(p<0.05)and kidney involvement(p<0.01).There was no significant difference in heart,skin,serous cavity,hematological and lung involvement(p> 0.05).In the immunological indicators,the C3 decreased and the positive rate of anti-U1 RNP antibody was significantly different between the two groups(p< 0.05).There were significant differences between the two groups in the level of immunoglobulin(p<0.05)and immunoglobulin G(p<0.01).4.In abdominal CT scanning,9 cases showed different sites and different degree of edema and thickening of intestinal wall.4 cases showed inflammation and exudation around the wall of intestine.3 cases showed different degree of abdominal effusion and 1 case showed intestinal tube dilatation.13 cases of abdominal B-mode Ultrasonography suggesting different degree of peritoneal effusion,8 cases of renal cyst,5 cases of chronic cholecystitis,5 cases of cholecystolithiasis,3 cases of hydronephrosis with bilateral ureteral dilatation,2 cases of splenomegaly.6 patients with different degrees of intestinal obstruction were indicated in abdominal X-ray,3 cases are suggestive of different degrees of peritoneal effusion,2 cases of ureteral stone.In 7 cases of echocardiography,5 cases showed different degree of pulmonary hypertension,5 cases showed ventricular thickening,5 cases showed different degree of valvular regurgitation,4 cases showed different degree of pericardial effusion.2 cases underwent gastroscopy,all of which indicated chronic atrophic gastritis,1 patient underwent colonoscopy and no obvious abnormalities were observed.5.SLEDAI score analysis of LMV patients found that mesenteric vasculitis can occur in mild or moderate to severe degree of disease activity.There was significant difference between the two groups in SLEDAI score of moderate activity(p<0.05).6.This group of 24 patients with LMV underwent glucocorticoid therapy,and all patients were effectively treated.At the same time,early combined with immunosuppressive therapy could control the progression of the disease.Conclusions LMV patients may have various clinical manifestations without specific test indicators,and involve multiple systems.Most of them were active SLE patients.Imaging examination is of great help in the diagnosis of SLE patients.Abdominal CT examination is of great significance in the diagnosis of LMV patients.Early use of glucocorticoid could effectively alleviate the symptoms of LMV patients and greatly improve the prognosis of the patients.