合并狼疮性肾炎的神经精神性狼疮患者痫性发作的危险因素分析  

Risk factors of epileptic seizure in patients with neuropsychiatric systemic lupus erythematosus complicated with lupus nephritis

作　　者：刘擘[1] 冯敏[1] 付莎[1] 徐安平[1] 

机构地区：[1]中山大学孙逸仙纪念医院肾内科,广州510120

出　　处：《新医学》2015年第9期593-596,共4页Journal of New Medicine

基　　金：广东省自然自由申请项目(S2012010009667)

摘　　要：目的：分析合并狼疮性肾炎（LN）的神经精神性狼疮（NPSLE）患者痫性发作的危险因素。方法收集115例 NPSLE 合并 LN 住院患者的临床资料，比较痫性发作者和非痫性发作者的临床特点，包括一般情况、器官受累情况、实验室检查及治疗，并采用单因素及多因素 Logistic 回归进行危险因素分析。结果115例 NPSLE 合并 LN 住院患者中，纳入痫性发作组53例，非痫性发作组62例。2组患者的 NPSLE 发病年龄、SLE 病程、血清白蛋白、血清总胆固醇、血清甘油三酯、血清LDL-C 水平比较差异均有统计学意义（P 均＜0.05）。多因素 Logistic 回归显示，NPSLE 合并 LN 患者痫性发作的独立危险因素包括未成年发病（OR ＝2.976，95％CI：1.044～8.475，P ＝0.041）、低白蛋白血症（OR ＝0.888，95％ CI：0.824～0.958，P ＝0.002）、LDL-C 偏高（OR ＝1.393，95％ CI：1.050～1.847，P ＝0.021）。结论未成年发病是合并 LN 的 NPSLE 患者痫性发作的独立危险因素，血清白蛋白水平越低、血 LDL-C 水平越高，痫性发作的危险性越高。Objective To determine the risk factors of epileptic seizure in patients with neuropsychi-atric systemic lupus erythematosus （NPSLE）complicated with nephritis lupus （LN）.Methods Clinical data of 115 hospitalized patients diagnosed with NPSLE complicated with LN were collected.Clinical characteristics including general conditions,involved organs,laboratory examination and treatment were statistically compared between the epileptic seizure and non-epileptic seizure patients.Univariate and multivariate logistic regression analyses were performed to analyze the risk factors.Results Among 115 NPSLE patients complicated with LN,53 were allocated into the epileptic seizure group and 62 into the non-epileptic seizure group.The age of onset of NPSLE,duration of systemic lupus erythematosus （SLE）,serum albumin,serum total cholesterol,se-rum triglyceride,serum low-density lipoprotein cholesterol （LDL-C）significantly differed between two groups （all P 〈0.05）.Multivariate logistic regression analysis revealed that juvenile onset （OR =2.976,95%CI：1.044 ～8.475,P =0.041）,hypoalbuminemia （OR =0.888,95%CI：0.824 ～0.958,P =0.002）,and high level of LDL-C （OR =1.393,95%CI：1.050 ～1.847,P =0.021）were the risk factors of epileptic seizures in NPSLE patients complicated with LN.Conclusions Juvenile onset is an independent risk factor of epileptic seizure in NPSLE patients complicated with LN.Lower levels of serum albumin and higher levels of serum LDL-C are associated with increased risk of epileptic seizure.

关 键 词：系统性红斑狼疮 神经精神性狼疮 狼疮性肾炎 痫性发作 危险因素 

分 类 号：R593.24[医药卫生—内科学]