儿童系统性红斑狼疮临床特点与起病年龄相关性研究

Correlations between the clinical characteristics and the onset age of childhood-onset systemic lupus erythematosus

目的探讨儿童期起病系统性红斑狼疮(SLE)临床特征及预后与起病年龄的相关性。方法回顾性分析2011年1月至2016年10月于重庆医科大学附属儿童医院风湿免疫科住院初诊为SLE患儿159例临床资料及预后,采用Spearman相关性分析评估其与起病年龄相关性。结果 159例SLE患儿平均起病年龄(11.05±2.73)岁,首发表现中,发热与起病年龄呈负相关(r=-0.164,P<0.05),白细胞下降(r=0.158,P<0.05)及神经系统受累(r=0.169,P<0.05)与起病年龄呈正相关,肾活检Ⅳ型狼疮性肾炎与起病年龄呈正相关(r=0.314,P<0.05)。其余首发临床表现、免疫学指标、治疗后并发症及死亡与起病年龄亦无明显相关性。结论儿童期SLE起病年龄越大,越易出现白细胞下降及神经系统受累,肾脏损伤更重,而炎性反应越小。经规范化治疗后,不同起病年龄并不能导致预后差异。

Objective To investigate the correlation between the clinical characteristics and onset age of childhood-onset systemic lupus erythematosus( SLE). Methods The clinical data and prognosis of SLE patients in our hospital from January 2011 to October 2016 were analyzed retrospectively,and the correlation between the clinical characteristics and onset age was evaluated by Spearman correlation coefficient analysis.Results In this study,the average onset age of the 159 SLE children was( 11.05±2.73) years old. Among the initial manifestations,fever was negatively correlated with the onset age( r =-0.164,P<0.05),leukopenia was positively correlated with the onset age( r = 0.158,P<0.05),nervous system involvement was positively correlated with the onset age( r = 0.169,P < 0. 05),and class Ⅳ lupus nephritis was positively correlated with the onset age( r = 0.314,P<0.05).There was no obvious correlation between the onset age and the other initial manifestations,immundogical indexes,the complications after treatment or death.Conclusion With the increase in onset age,it is more likely to have leukopenia and nervous system involvement,and serious renal damage is more severe,but the inflammatory response is less.After standardized treatment,the onset age doesn’t determine the prognosis of childhood-onset SLE.