系统性红斑狼疮常用指标与病情活动相关性研究

A Correlation Study on the Routine Parameters and Disease Activity of Systemic Lupus Erythematosus

目的探讨常用临床和实验室指标与系统性红斑狼疮(systemiclupuserythematosus,SLE)病情活动的相关性,并对目前常用的狼疮活动性评估标准中部分指标的选择及权重赋值问题进行一些评析。方法采用横断调查研究的方法,根据LACC标准对首次就诊的202例SLE患者病情进行分析,运用SPSS11.5软件对16项常用的临床和实验室指标与病情活动之间的关系进行Logistic回归分析。结果根据LACC标准,202例患者有104人病情缓解(51.5%),98人病情活动(48.5%)。Logistic回归分析显示,抗ds-DNA抗体(OR=13.756,P=0.000)、补体(OR=10.392,P=0.001)、尿常规(OR=8.191,P=0.002)、血常规(OR=7.329,P=0.004)、皮疹(OR=11.601,P=0.005)、脱发(OR=8.390,P=0.005)、黏膜溃疡(OR=9.069,P=0.007)及血沉(OR=3.809,P=0.037)与病情活动有显著相关性(P<0.05),而其余指标则与病情活动无显著相关性(P>0.05)。结论目前常用的狼疮活动性评估标准中部分指标的选择及权重赋值存在问题。可以利用抗ds-DNA抗体、补体、尿常规、血常规、皮疹、脱发、黏膜溃疡和血沉方便地监测SLE患者的病情。

Objective To explore the relationship between routine clinical symptoms as well as laboratory tests and the lupus activity in patients with systemic lupus erythematosus (SLE) and to commentate some selected items as well as weighted scores on the current most commonly used criteria in assessing SLE disease activity. Methods A cross-sectional study was performed in 202 patients with SLE at their first visit and disease activity status of them was assessed according to the lupus activity criteria count (LACC). The correlation between the 16 routine clinical symptoms as well as laboratory tests and disease activity status were analyzed by Logistic regression with SPSS 11.5. Results According to the LACC, 104 (51.5%) among those 202 outpatients went into remission, while the other 98 patients (48.5%) were active. Logistic regression analysis suggested that anti-dsDNA antibody(OR=13.756,P=0.000), complemental components(OR=10.392,P=0.001), urine routine examination(OR=8.191,P=0.002), blood routine examination(OR=7.329,P=0.004), skin lesions(OR=11.601,P=0.005), alopecia(OR=8.390,P=0.005), mucous membrane ulcers(OR=9.069,P=0.007) and erythrocyte sedimentation rate(ESR)(OR=3.809,P=0.037)significantly correlated with the disease activity (P<0.05), while other parameters negatively correlated with the disease activity(P>0.05). Conclusion There were some defects in selecting and weighing the items most commonly used in assessing SLE activity today. Anti-dsDNA antibody, complemental components, urine routine examination, blood routine examination, skin lesions, alopecia,mucous membrane ulcers and ESR could be conveniently used in monitoring disease activity in patients with SLE.