影响系统性红斑狼疮活动指数评分的主要指标分析  

The analysis of key indicators what may affect the acticity index in systemic lupus erythematosus

作　　者：李吴萍[1] 王海英[2] 杨霞[3] 宫怡[2] 纪梅[1] 

机构地区：[1]宁夏医科大学公共卫生学院流行病与卫生统计学系,银川750004 [2]宁夏医科大学总医院风湿免疫科 [3]宁夏医科大学总医院病案科

出　　处：《中华风湿病学杂志》2012年第5期343-345,共3页Chinese Journal of Rheumatology

基　　金：基金项目：宁夏自然科学基金（NZ0877）

摘　　要：目的探讨系统性红斑狼疮（SLE）住院患者的分布特征、临床表现、实验室指标及活动指标，为临床诊断提供更多的参考。方法收集2006年1月至2010年6月宁夏医科大学总医院1037例SLE住院患者的病案资料。采用t检验和矿检验进行统计学分析。结果5年住院病例呈逐年上升趋势；发病特点以20～40岁女性最为常见，占67．5％，男女比例为1：8．26。关节痛是最常见的首发症状，占54．3％，其次是皮疹，占48．2％；补体c3下降、蛋白尿、血小板降低和抗dsDNA阳性可以作为SLE早期诊断的指标。综合分析SLE疾病活动指数（SLEDAI）〉9的患者占26．0％，影响SLEDAI活动指数评分的主要指标是：发热、关节痛、皮疹、蛋白尿、补体降低、抗dsDNA抗体滴度升高、胸膜炎、脱发、口腔溃疡、心包炎、活动性神经精神症状、血小板降低；活动组在发热、关节痛、皮疹、面部红斑、肺脏损害、脱发、口腔溃疡、心脏损害、神经精神症状和肾脏损害等的发生率均高于非活动组。抗dsDNA抗体滴度、红细胞沉降率和c3、c4水平异常发生率等指标在活动组均高于非活动组。结论SLE是多系统、多脏器受累的疾病，在临床症状和免疫学指标上有其特征性改变，因而重视早期诊断，掌握疾病的发病特征和规律，正确判断病情的活动，对采取合理有效的治疗，延缓SLE患者病情发展，改善预后具有重要意义。Objective To investigate the distribution of characteristics, clinical manifestations, laboratory parameters and activity index of patients with systemic lupus erythematosus （SLE） and to determine their role in helping to make correct clinical diagnosis and disease the activity evaluation of SLE. Methods Collect the data of 1037 SLE patients of Ningxia Medical University Affiliated Hospital from January 2006 to June 2010. Data were analyzed with t test and Chi-square test. Results Over the past three years, there were more and more patients were admitted year by year. Among the 1037 cases of SLE patients, most of them 20-40 year-old woman, accounting for 67.5% of the whole patient population, with a male to female ratio was 1：8.26. Joint pain was the most common initial symptom, accounting for 54.3%, followed by skin rash, accounting for 48.2%. Decreased complement C3 level and platelets counts, proteinuria, and positive anti-dsDNA antibody could be used as indicators for early diagnosis of SLE. SLEDAI activity score higher than 9 were presented in 26.0% of patients. Factors that could impact the final score of SLEADI were fever, arthritis, skin rash, proteinuria, low complement levels, high titers of anti-dsDNA antibody, pleurisy, alopecia, mucosal ulcers, pericarditis, mental illness and decreased platelets count. Patients with active disease had a higher accidence of fever, arthritis, skin rash, lung damage, alopecia, mucosal ulcers, heart damage, mental illness and renal damaged, low complement levels, high level of anti-dsDNA antibody titers and elevated erythrocyte sedimentation rate. Conclusion SLE is a multi-system disease with multiple organ involvement, with characteristic clinical symptoms and immunological abnormalities, thus early diagnosis is very important. Understanding the characteristics of the diseases, correct judgement of the disease activity, reasonable and effective treatment all can delay the development of organ damage and improve the prognosis.

关 键 词：红斑狼疮 系统性 SLEDAI 回顾性研究 

分 类 号：R593.241[医药卫生—内科学]