Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple systems and organs, with complex clinical manifestations and prolonged and repeated course of disease. SLE patients are widely distributed all over the world, with great regional differences. It is estimated that there are about one million SLE patients in China, and the trend is increasing year by year. Most of them are women of childbearing age. In the past, due to the lack of understanding of the disease, SLE patients had a high mortality rate, so people had fear and even compared it with cancer. In recent 20 years, due to the rapid development of clinical immunology, the early diagnosis and treatment of SLE is no longer a difficult problem. As long as most patients get the correct diagnosis and treatment from doctors, especially insist on long-term follow-up, their condition can be controlled and their life is very good. Many people have also organized happy families, raised children and improved their quality of life. According to statistics, the 10 annual survival rate of SLE patients in China is over 84%, which is already at the international advanced level.

How to diagnose whether you have systemic lupus erythematosus?

At present, the classification standard revised by American Rheumatology Association 1982 is usually adopted. 1, butterfly erythema on face 2, disk erythema 3, sun allergy 4, oral or nasopharyngeal ulcer 5, non-invasive arthritis 6, serositis 7, renal damage 8, neuropathy: seizure or psychosis 9, hematological abnormalities: hemolytic anemia, leukopenia, lymphopenia or thrombocytopenia. 10, immunological abnormality: lupus cells are positive, anti-DS-DNA antibody is positive, anti-SM antibody is positive, or 6-month anti-syphilis serum test is false positive 1 1, and antinuclear antibody is positive. Clinically, under the premise of excluding other diseases, if there are four or more manifestations in the above-mentioned 1 1 standard, please note: because the diagnosis of SLE is complicated, you must go to a regular hospital and be diagnosed by a specialist, and you can't diagnose yourself to avoid misdiagnosis.

What are the early manifestations of systemic lupus erythematosus?

SLE is a systemic disease, including skin, muscle, bone, heart, lung, liver, spleen, kidney, brain, eyes, nose, ears, teeth and hair. Such as: fever, fatigue, loss of appetite, general malaise, joint swelling and pain, muscle soreness, weight loss, alopecia, facial erythema, fingertip rash, white or purple hands and feet after a cold, recurrent oral ulcer, superficial lymphadenopathy, menstrual bleeding, skin purpura, anemia, leukocytosis, thrombocytopenia, headache, hallucination, auditory hallucination, numbness, intractable diarrhea and vomiting.

How do patients choose treatment methods?

Be sure to go to a regular hospital for treatment. Through regular examination and examination, we can confirm whether we have SLE, and treat and use drugs under the guidance and supervision of specialists. Don't listen to advertisements, take medicine by yourself, or increase or decrease the dosage or stop taking medicine according to your self-feeling.

What laboratory and instrument tests do patients need to do?

1, antinuclear antibody spectrum: titer >; 1: 20 has clinical significance. Among them, anti-ds-DNA antibody is SLE-specific antibody, which is related to disease activity and prognosis. Anti-Sm antibody and anti-Rib antibody are labeled antibodies and do not represent the activity of the disease. Patients with positive anti-SSA and anti-SSB antibodies often have symptoms such as dry mouth and dry eyes, and patients with positive anti-RNP antibodies often have Raynaud phenomenon. 50% ~ 70% patients are positive for anti-histone antibodies.

2, skin lupus band test: patients in the skin epidermis and dermis junction, there will be immune complex deposition. Take skin biopsy, and under the fluorescence microscope, we can see that the junction between epidermis and dermis is linear grass green fluorescence. It's called skin lupus band test. Lupus band is helpful for the diagnosis of SLE, but it is not unique to SLE patients. However, a strong positive lupus band test often shows that systemic lupus erythematosus is possible.

3, erythrocyte sedimentation rate, blood routine, urine routine

4. Serum complement C3, C4, CH50: The complement level is negatively correlated with SLE activity, and the serum complement is extremely low, so the disease is in a progressive stage.

5. Circulating immune complex: SLE increased in active phase.

6. Serum protein electrophoresis: the serum γ globulin or α2 and β globulin increased in the active period and returned to normal after treatment.

7. Rheumatoid factor: 20% ~ 30% of SLE patients are positive for rheumatoid factor.

8. Anti-phospholipid antibody: The existence of anti-phospholipid antibody can cause arteriovenous embolism; It can also lead to thrombocytopenia and bleeding. In addition to encephalopathy, antiphospholipid antibodies can also cause stillbirth or abortion.

How do you know SLE has recurred?

Recurrence of the disease should be considered if the following symptoms and laboratory tests are abnormal.

1) fever of unknown cause. That is, fever cannot be explained by colds, throat, lung and urinary tract infections, nor is it caused by other diseases;

2) a fresh rash or vasculitis-like rash appears at the tip of the finger or other parts;

3) joint swelling and pain occur again;

4) obvious hair loss;

5) fresh ulcer of mouth and nose;

6) pleural effusion or pericardial effusion;

7) Increased proteinuria;

8) Leukopenia or thrombocytopenia or anemia is obvious;

9) nervous system symptoms, such as headache, vomiting and convulsions;

10) the titer of anti-double stranded DNA antibody increased;

1 1) the erythrocyte sedimentation rate increased rapidly, reaching more than 50 mm/h;

12) complement decreased, especially C3 decreased. I suggest you follow the doctor's advice regularly.

Questions about the life of systemic lupus erythematosus patients ABC?

Can SLE patients get married? According to the current treatment, the condition of most patients can be well controlled, and they can get married after the condition is controlled. Moreover, the life, comfort, support and encouragement of married partners help to control the disease and help patients build confidence in overcoming the disease. Can SLE affect sexual function? The structure and function of sexual organs in SLE patients are generally unchanged, which will not affect sexual desire and sexual function, and will not aggravate the condition due to sexual life. It is worth noting that some patients will have sexual dysfunction after using certain drugs, such as tripterygium wilfordii. Therefore, the side effects of drugs should be considered in the treatment. Can SLE have children? Lupus erythematosus is not an infectious disease, nor is it a genetic disease like Down syndrome or mental illness, so it is entirely possible to get married and have children with lupus erythematosus. However, the development of the disease must be controlled in the long-term follow-up of doctors. Generally, low-dose hormones are used, and the condition is stable 1 year or more. Getting married and having children can be considered. What should SLE patients pay attention to during pregnancy? Pay close attention to your perinatal physical changes, such as blood pressure, breathing, foam urine, rash and so on. Always contact the specialist, make detailed records, let the specialist know about your condition, and at the same time conduct regular prenatal examination to keep abreast of the development of the fetus in the uterine cavity and whether the maternal condition has changed. In the early pregnancy, you must not use some drugs that are unfavorable to the fetus. Eat more fresh fruits to increase nutrition and feel comfortable. At the same time, the thoughtfulness and comfort between husband and wife is the biggest spiritual pillar of pregnant women. Can SLE be inherited? The pathogenesis of SLE is the result of many factors, which are influenced by heredity, environment, infection, endocrine and autoimmune status. This disease can only be called genetic susceptibility, not genetic disease. Most patients' children are normal, healthy and lively. Why does exposure induce SLE? About 40% SLE patients will be sensitive to light, and ultraviolet rays in sunlight will induce diseases. Therefore, photosensitive patients, if the weather is sunny when they go out, had better wear a hat or an umbrella to avoid direct ultraviolet radiation and aggravate their illness. Can SLE patients use cosmetics? Some cosmetics contain chemical reagents, especially those containing aromatic amines, which can induce lupus. There are also cases of lupus after dyeing hair or tattooing eyebrows. So in order to avoid the stimulation of chemicals, it is best not to use cosmetics. What should the diet of SLE patients pay attention to? There are no special taboos in the diet of SLE patients. However, some foods, such as celery, figs, mushrooms, smoked foods, alfalfa seeds and pods, can induce lupus erythematosus and should be avoided as much as possible. Pay attention to a low-salt diet and eat more fruits and vegetables rich in potassium such as bananas, apples, oranges and tomatoes. However, if patients have renal failure and high blood potassium, they can't eat foods with high potassium, and diabetics need to limit staple foods and sweets. In short, SLE patients should have a light diet with low salt, low fat and high protein. What drugs can induce SLE? The drugs that can definitely induce SLE are hydralazine, procainamide, isoniazid, chlorpromazine and methyldopa.

The drugs that may be induced are: phenytoin sodium, penicillamine, quinidine, propranolol (propranolol), hydroxyprolol (propranolol), pyrithione, trimethyldione, ethosuximide, reserpine, captopril (captopril), methimazole (tabazole), nitrofurantoin, tartrate and silica gel for plastic surgery.

Unknown drugs include: sulfanilamide, griseofulvin, phenylbutazone, oral contraceptives, penicillin, streptomycin, tetracycline, primidone and so on.

After the disease is controlled, SLE patients should try not to take the above drugs, so as not to aggravate or complicate the condition. Can SLE be cured? The etiology of SLE is still unclear, and neither traditional Chinese medicine nor western medicine can cure it at present. But with enough drugs to relieve the disease for a long time, patients can live a normal life.

Principles of treatment of systemic lupus erythematosus

Active stage should be actively treated and relieved; In remission period, medication should be adjusted to reduce the side effects of drugs and prevent the recurrence of diseases. Patients should do five things instead of five things. Five essentials: follow the doctor's advice, get enough rest, have a cheerful personality, eat properly, and check regularly. Five noes: do not use drugs indiscriminately, do not overwork, do not expose to the sun, do not listen to hearsay, and do not suddenly stop taking drugs. Medical workers are trying to find out the cause of this disease. I believe that SLE will be completely cured one day in the near future.

How should lupus patients take care of themselves?

Patients with lupus erythematosus should strengthen their own care, which also plays a key role in the prognosis of the disease. Patients should be optimistic and have a good mood, and help them build confidence to overcome the disease. For patients with mild illness, it is necessary to arrange their diet and daily life reasonably, such as eating more high-protein and nutritious food. Except celery and fungi, there is no need to avoid eating chicken, duck, meat and seafood. Pay attention to rest, sleep for more than 8 hours at night, and take a nap in the afternoon 1 hour. Photosensitive patients should avoid sunlight when they go out. Patients with different manifestations of lupus erythematosus can be given corresponding care according to the situation: (

1) Facial erythema: Keep your face clean, wash your face often with clean water, and wet apply erythema with warm water of about 30℃. Avoid using alkaline soap, inferior cosmetics, etc.

(2) Oral and nasal mucosal ulcers: keep oral hygiene, clean your mouth after meals, brush your teeth with a soft toothbrush and apply iodine glycerin locally.

(3) Hair loss: Wash your hair with warm water and massage your scalp while washing.

(4) Stay in bed for a long time: pay attention to prevent bedsores, turn over more, keep local cleanliness, pat your back to help expectorate, and pay attention to the changes in urine and urine.

(5) Pay attention to the side effects of drugs, such as melena, skin acne, hip pain and blurred vision. , and promptly report to the responsible doctor and take measures.

In a word, good nursing is very important for the development and recovery of lupus erythematosus, and sometimes it can even play a role that drugs can't achieve.

Can lupus erythematosus work normally after its condition is controlled?

Suffering from lupus erythematosus, patients often have a pessimistic mood, thinking that the disease is incurable and will always die. Some even commit suicide for life, and some stay at home for a long time and dare not work, passively dying. In fact, these ideas are all wrong. We didn't know enough about this disease before, and the mortality rate was high. But in the past 20 years, the treatment of this disease has made great progress, and there are more and more treatment methods. After correct treatment, many patients can be relieved for a long time, so lupus erythematosus is not terrible. What is terrible is ideological pessimism and disappointment. As a patient, we must first understand our own condition, communicate with doctors constantly, and learn some knowledge about disease prevention and treatment. After proper treatment, most patients have been able to control and stabilize their illness, many patients have recovered their ability to work, and some even have the courage to lose their "iron rice bowl" and choose a road full of risks and difficulties to achieve something. As a doctor, I don't want patients to stay at home and lie in hospital beds for a long time. When the patient's condition is under control, it is beneficial to the patient's treatment to get in touch with the society, reduce psychological pressure, take part in work and contribute the learned knowledge to the society. As family members of patients, we should understand patients, actively encourage patients to face diseases, society and life, and help patients overcome mental illness and face life with the cooperation of doctors, patients and family members. Of course, the first condition is to control the illness well before you can take part in some work within your power.

What is the treatment principle of lupus erythematosus?

Lupus erythematosus is not like a cold, just buy some medicine at the drugstore. Lupus erythematosus is a complex disease, which needs long-term follow-up treatment by experienced doctors to control the disease. However, the principle of treatment requires doctors to understand patients and their families and cooperate with doctors to control the recurrence of diseases.

(1) Know the severity of the illness: Just like fighting a war, you need to be familiar with the situation first. Generally speaking, arthritis, oral ulcer, rash or pleurisy are mild clinical manifestations, while diffuse nephritis, central nervous system involvement, hemolytic anemia and thrombocytopenia are serious manifestations of the disease.

(2) Individualization: Each patient's response to drug treatment is different, so the treatment plan and drug dosage must be individualized. After a period of treatment, the drug should be controlled at an appropriate dose to prevent the recurrence of the disease.

(3) Risk/effectiveness ratio: The risk/effectiveness ratio of the selected drugs and doses to patients should be evaluated every time. Many drugs have both curative effects and side effects. Therefore, in the course of treatment, it is necessary to find the most suitable drug and dosage between controlling disease activity and drug toxicity.

(4) Follow-up: Long-term follow-up should be conducted regardless of whether the disease is controlled or not, and comprehensive examination should be conducted every 1- 12 months according to the disease. Long-term remission can try to stop taking drugs.

(5) Anti-nuclear antibodies and treatment: Various anti-nuclear antibodies, including anti-RNP, anti-Sm, anti-SSA and other antibodies, are important signs for diagnosing diseases, rather than indicators for evaluating curative effects. This is very important for both doctors and patients to remember. If only antinuclear antibodies are positive without clinical manifestations, treatment is generally not needed, but patients with high titer of anti-double stranded DNA antibodies should be alert to disease activities, especially lupus nephritis.

(6) Photosensitivity: Only 40% of patients with lupus erythematosus have photosensitivity. Not all patients should avoid sunlight. Only some patients with severe rash or a history of photosensitivity should pay attention to this problem. It's best to take an umbrella when going out on a sunny day to avoid direct sunlight.

(7) Improving the quality of life: As the therapeutic effect of lupus erythematosus is getting better and better, the long-term survival rate is constantly improving, and improving the quality of life of patients is placed in an important position. Give mental support to patients. At the beginning of treatment, rest is very important. However, when the symptoms can be completely controlled by drugs, patients should be encouraged to take appropriate jobs and children should return to school as much as possible. After long-term control or remission, you can consider getting married and having children.

In short, the treatment of lupus erythematosus is like painting. Pigments, paper and pens are all ready, waiting for doctors, patients and their families to conceive and paint.