摘要
系统性红斑狼疮（Systemic lupus erythematosus，SLE）是一种以多系统受累和自身抗体形成为特征的自身免疫性疾病。抗磷脂综合征（antiphospholipid syndrome, APS）是一种血栓炎症性疾病，以血栓形成、病态妊娠和抗磷脂抗体阳性为特征，多达三分之一的SLE患者会继发APS。APS可引发动脉、静脉和微血管的血栓形成，常见部位包括下肢深静脉和脑动脉，也可发生在特殊部位如内脏动脉和脑静脉窦，微血管血栓还可累及皮肤、眼、心、肺、肾等多个器官。二者重叠出现时往往导致病情更为复杂，诊治难度显著增加。本文报道1例以咳嗽、痰中带血为首发症状，病程中相继出现血小板减少、颅内静脉窦血栓、肺栓塞等多系统损害表现的SLE，旨在强调早期识别、多学科协作的重要性，以免造成漏诊、误诊，为类似病例的诊治提供参考。
关键词： 系统性红斑狼疮；抗磷脂综合征；多发性血栓；重叠综合征；早期识别
Abstract
Systemic lupus erythematosus is an autoimmune disease characterized by multiple organ involvement and the formation of autoantibodies. Antiphospholipid syndrome is a thrombotic inflammatory disease, characterized by thrombosis, pathological pregnancy and positive antiphospholipid antibodies. Up to one-third of SLE patients will develop APS secondary to the disease. APS can cause thrombosis in arteries, veins and microvessels, and common sites include deep veins of the lower extremities and cerebral arteries. It can also occur in special sites such as visceral arteries and cerebral venous sinuses. Microvascular thrombosis can also affect multiple organs such as skin, eyes, heart, lungs and kidneys. When both conditions occur simultaneously, they often lead to more complex conditions and significantly increase the difficulty of diagnosis and treatment. This article reports a case of SLE with cough and blood in sputum as the initial symptoms, followed by multiple system damage manifestations such as thrombocytopenia, intracranial venous sinus thrombosis and pulmonary embolism during the course of the disease. The aim is to emphasize the importance of early identification and multidisciplinary collaboration to avoid missed diagnosis and misdiagnosis, and to provide a reference for the diagnosis and treatment of similar cases.
Key words： Systemic lupus erythematosus; Antiphospholipid syndrome; Multiple thrombosis; Overlap syndrome; Early identification
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