系统性红斑狼疮并发类固醇糖尿病患者临床特点和危险因素分析

Clinical characteristics and risk factors of steroid diabetes mellitus in patients with systemic lupus erythematosus

目的分析系统性红斑狼疮（SLE）并发类固醇糖尿病（SDM）患者的临床特点和危险因素。方法回顾性分析2006年2月至2013年6月在广州医科大学附属第二医院住院的14例并发SDM的SLE患者临床资料,并与性别、发病年龄相匹配的100例无合并SDM的SLE患者比较。结果 14例SLE合并SDM患者中男1例,女13例,平均年龄（48.0±10.3）岁。4例SDM患者出现＂三多一少＂症状,4例空腹和餐后血糖均升高,10例餐后血糖升高。SDM患者使用口服降血糖药和（或）胰岛素治疗。单因素比较发现,SLE并发SDM组患者关节炎、肾脏病变、高血压、高胆固醇血症、高甘油三酯血症、高尿酸血症患者增多,差异有统计学意义（P〈0.05）。多因素Logistic回归分析显示,高胆固醇血症是SLE患者并发SDM独立危险因素（OR 12.942,95%CI：2.994~41.316,P=0.000）。结论 SLE患者并发SDM患者关节炎、肾脏病变、高血压、高胆固醇血症、高甘油三酯血症、高尿酸血症者增多,高胆固醇血症是SLE患者并发SDM独立危险因素。

ObjectiveTo analyzeclinical characteristics and risk factors of steroid diabetes mellitus （SDM） in patients with systemic lupus erythematosus （SLE）.MethodsFourteen medical records of SLE patients with SDM and 100 randomly-matched records of SLE patients without SDM were reviewed, the clinical data were compared between the two groups.Results Fourteen patients with SLE complicating with SDM included 1 man and 13 women, with the mean age of （48.0＆#177;10.3）years. Four patients of them had diuresis, polydipsia, polyphagia or maransis. Four patients with SDM had high fasting blood glucose and high postprandial blood glucose, and ten patients with SDM had high postprandial blood glucose. Hypoglycemic drugs and/or insulin were prescribed for patients with SDM. There was significant difference between SLE patients with SDM and SLE patients without SDM in arthritis, nephropathy, hypertension, hypercholesterolemia, hypertriglyceridemia, hyperuricemia （P〈0.05）. Hypercholesterolemia was an independent risk factor for SDM in SLE patients（OR 12.94, 95%CI 2.994-41.316,P=0.000）. ConclusionsThere is an increased rate for SLE patients with SDM in arthritis, nephropathy, hypertension, hypercholesterolemia, hypertriglyceridemia and hyperuricemia. Hypercholesterolemia is an independent risk factor for SDM in SLE patients.