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摘要：
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摘要：目前，关于乙型肝炎病毒感染合并系统性硬化症的报道较少。本例患者为56岁
中年女性，患慢性乙型肝炎16年，突发面部红斑1个月，查体可见面部皮肤肿胀并鼻翼
旁、额头毛细血管扩张，躯干处皮肤发硬并弥漫性色素沉着斑夹杂色素减退，双手指
皮肤弹性差，指尖变细，雷诺征阳性。根据2013年美国风湿病学学会/欧洲抗风湿病联
盟（ACR/EULAR）发布的分类标准诊断为乙型肝炎失代偿期肝硬化合并系统性硬化
症，但该患者已进展至失代偿期肝硬化，治疗存在局限性，预后差。临床医师在慢性
乙型肝炎患者管理中应注重体格检查，识别系统性疾病相关症状体征、注意筛查自身
抗体，早期识别和诊断系统性硬化症，以便早期干预，改善预后。
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Abstract: At present, few literature reports on the co-existence of hepatitis B virus infection and
systemic sclerosis had been reported. The case was a 56-year-old woman with chronic hepatitis B
for 16 years and had sudden facial erythema for 1 month. Physical examination showed swelling
of the facial skin, dilatation of capillaries near the nose and forehead, stiff skin on the trunk and
diffuse pigmentation spots with hypopigmentation, poor elasticity of the fingers on both hands,
thinning of the fingertips and positive Raynaud sign. According to the classification criteria issued
by the American College of Rheumatology/European League against Rheumatism in 2013, the
patient was diagnosed with hepatitis B related decompensated cirrhosis complicated with systemic
sclerosis, and the patient had progressed to the decompensated stage of cirrhosis with limited
treatment and poor prognosis. Clinicians should pay attention to physical examination in the
management of patients with chronic hepatitis B, identify symptoms and signs related to systemic
diseases, screen for autoantibodies, and identify and diagnose systemic sclerosis early in order to
intervene early and improve the prognosis.
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