狼疮肾炎合并静脉血栓栓塞的危险因素

Risk Factors of Lupus Nephritis Combined with Venous Thrombotic

目的 探索狼疮肾炎(LN)患者发生静脉血栓栓塞(VTE)的风险因素。方法 收集2019年4月至2022年3月于郑州大学第一附属医院住院的LN合并VTE患者的临床资料,随机抽取2倍数量该院同期收治的未合并VTE的LN患者作为对照组。比较两组患者相关指标的差异,并应用logistic回归分析筛选出独立危险因素。结果 合并VTE的LN患者共46例,中位病程为9.0(2.0,40.0)个月。相较于未合并VTE的LN患者,合并VTE的LN患者病程更短,D-二聚体水平、高脂血症、C反应蛋白(CRP)>10 mg·L^(-1)和抗磷脂抗体(aPLs)阳性的比率及泼尼松日用量更高(P<0.05)。多因素logistic回归分析显示合并高脂血症(OR=3.831,P=0.019)、CRP>10 mg·L^(-1)(OR=3.865,P=0.013)、aPLs阳性(OR=4.968,P=0.003)的LN患者具有较高的VTE风险。结论 高脂血症、CRP>10 mg·L^(-1)、aPLs阳性是LN患者发生VTE的独立危险因素。对存在上述风险因素,尤其是处于疾病早期的患者应提高警惕,必要时早期预防和及时干预,改善LN患者的预后。

Objective To explore the risk factors of lupus nephritis(LN)patients combined with venous thromboembolism(VTE).Methods The clinical data of LN patients complicated with VTE admitted to the First Affiliated Hospital of Zhengzhou University from April 2019 to March 2022 were collected.Two times the number of LN patients admitted to the hospital during the same period without VTE were randomly selected as the control group.The data of the two groups was compared to observe the differences,and the independent risk factors were screened by logistic regression analysis.Results There were 46 LN patients combined with VTE,and the median disease course of LN was 9.0(2.0,40.0)months.Compared with LN patients without VTE,LN patients with VTE had shorter duration and higher level of D-dimer,hyperlipidemia,C-reactive protein(CRP)>10 mg·L^(-1),positive antiphospholipid antibodies(aPLs),and the higher daily dose of prednisone(P<0.05).Multivariate logistic regression analysis showed that hyperlipidemia(OR=3.831,P=0.019),CRP>10 mg·L^(-1)(OR=3.865,P=0.013)and positive aPLs(OR=4.968,P=0.003)were associated with a higher risk of VTE in LN patients(P<0.05).Conclusion Hyperlipidemia,CRP>10 mg·L^(-1),positive aPLs are independent risk factors for VTE in LN patients.Patients with the above risk factors,especially those in the early stage of the disease,should be vigilant,early prevention and timely intervention if necessary to improve the prognosis of patients with LN.