系统性红斑狼疮合并溶血性贫血患者病情活动度脏器损害程度及相关实验室检查的特点

Characteristics of Disease Activity Index,Organ Damage Index and Relative Lab Results of SLE with HA

目的探讨系统性红斑狼疮(SLE)患者合并溶血性贫血(hemolytic anemia,HA)发生率与SLE病情活动指数(DAI)、脏器损伤指数(SDI)、抗心磷脂(aCL)抗体阳性率、抗双链DNA(ds-DNA)抗体阳性率及肾脏、神经精神系统受累率的关系。方法分析453例SLE患者的临床资料及相关实验室指标,应用χ2检验进行统计学分析。结果 453例SLE患者中,213例(占47%)无贫血,193例(占42%)合并非溶血性贫血,合并溶血性贫血者47例(占10.3%)。溶血性贫血组DAI(17.6分±6.1分)、SDI(1.83分±1.8分)、aCL抗体阳性率(33.8%)、肾脏、神经精神系统受累率(81.7%和32.6%)高于非贫血组(上述指标,分别为10.6分±5.3分、1.1分±1.3分、24.7%、43.9%和18.0%)及非溶血性贫血组(上述指标分别为13.7分±4.2分、1.2分±1.0分、24.1%、57.6%和19.1),且具有统计学意义(P<0.05)。溶血性贫血组抗dsD-NA抗体阳性率为73.4%高于非贫血组(55.7%)及非溶血性贫血组(61.2%),且与非贫血组的差异具有统计学意义(P<0.05)。结论 SLE发生HA者有更高的病情活动度、损伤指数、肾脏、神经精神系统受累率及抗ds-DNA抗体和aCL抗体阳性率。

Objective To observe the relation between systemic lupus erythematosus（SLE） patients with hemolytic anemia（hemolytic anemia,HA） and SLE disease activity index（DAI）,organ damage index（SDI）,anticardiolipin（aCL） antibody positive rate,anti-double-stranded DNA（ds-DNA） antibody positive rate,the kidneys and Neuropsychiatric involvement.Methods We analyzed the clinical feature and laboratory parameters of 453 cases of SLE patients,and applied χ2 test for statistical analysis.Results Among 453 cases of SLE patients,213 patients（47%） without anemia,193 patients（42%） with non-hemolytic anemia,47 patient（10.3%） combined hemolytic anemia.Hemolytic anemia group had highter rate of DAI,SDI,aCL antibody positive rate,kidneys,nervous-mental system involvement rate than the other two groups,and the results had statistically significant.In hemolytic anemia group,anti-dsDNA antibody positive rate was 73.4% higher than non-anemic group and non-hemolytic anemia group,and with non-anemia group difference was statistically significant.Conclusion SLE combined with HA might have highter disease activity index,damage index,anti-dsDNA antibodies and aCL antibody positive rate,and higher occurrence of kidney,nervous and mental system involvement.