系统性红斑狼疮的家庭聚集性研究

The Study on Familial Aggregation of Systemic Lupus Erythematosus

目的 研究系统性红斑狼疮(SLE)的家庭相关,探讨系统性红斑狼疮家庭聚集的因素来源。方法 应用广义估计方程2 (GEE2 )对上海地区的2 5 6个SLE家系(共1873例家系成员)调查资料进行了分析。GEE2可同时估计均数结构和关联结构的边际回归模型。所有的估计都在软件MAREG中实现。结果 调整了性别、年龄和家庭成员间疾病相关后,发现疱疹病毒感染史、药敏史与SLE存在很强的关联,其OR值分别为15 .2 6(95 %CI:1.73- 134.2 9)和2 2 .78(95 %CI :6 .11- 10 1.6 3)。调整性别、年龄和环境危险因素(包括冻疮史、疱疹病毒感染史及药敏史)的作用后,亲子间的边际OR值2 .72 (95 %CI :0 .86 - 8.5 8)和同胞间的边际OR值3.73(95 %CI:1.30 - 10 .6 4 )高于配偶间的边际OR值2 .11(95 %CI:0 .2 1- 2 1.0 7) ,同胞间的边际OR值有统计学意义。另外,环境协变量调整前,亲子间和同胞间的边际OR值分别为:2 .72 (95 %CI :0 .90 - 8.2 6 )和3.6 7(95 %CI:1.35 - 9.95 ) ,与调整后亲属间SLE疾病状态的家庭相关的大小相近。结论 SLE有明显的家庭聚集性,很大程度上可以由遗传因素来解释。

Purpose To study familial aggregation of sy stemic lupus erythematosus (SLE) and to determine the weight of genetic and envi ronmental factors contributing to familial aggregation of the disease. Methods Data from a genetic epidemiologic study on SLE in Shanghai was analyzed by using generalized estimating equation 2 (GEE2),which can estimate both regression coefficients and familial correlation.Analyses was carried out by using software MAREG. Results SLE had strong association with a history of al lergy to medications (OR:15.26,95%CI:1.73-134.29),and with a history of herpes zoster (shingles) (OR:22.78,95%CI:6.11-101.63) after adjusting gender,age and fa mily correlation of relative pairs.The m arginal OR between parents and offspring (2.72,95%CI:0.86-8.58) and between sib lings (3.73,95%CI:1.30-10.64) were higher than those between two parents (2.11, 95%CI: 0.21-21.07) after adjusting gender,age and other environmental covar iate s.In addition,The marginal OR between parents and offspring and between siblings were 2.72 (95%CI:0.86-8.58)and 3.67 (95%CI: 1.35-9.95) without adjusting env ironmental risk factors,which was approximative to those relative pa irs after adjusting those factors. Conclusions The occurrence of SLE had strong famil ial aggregation which was mostly caused by genetic factors.