胸部CT对系统性红斑狼疮淋巴结肿大的评估及其与疾病进程关系的研究  

Exploration of chest CT assessment for lymph node enlargement in systemic lupus erythematosus and the relationship of that with disease progression

作　　者：李静[1] 马芹 路磊[2] Li Jing;Ma Qin;Lu Lei(Department of Rheumatology and Immunology,The People's Hospital of Bozhou,Bozhou 236800,China;Department of Orthopedics,The People's Hospital of Bozhou,Bozhou 236800,China)

机构地区：[1]亳州市人民医院风湿免疫科,亳州236800 [2]亳州市人民医院骨科,亳州236800

出　　处：《中国医学装备》2024年第4期46-50,共5页China Medical Equipment

基　　金：安徽省科学技术厅课题(2021J01498)。

摘　　要：目的:探讨胸部CT对系统性红斑狼疮淋巴结肿大的评估价值及其与疾病进程的关系。方法:选择2020年7月至2023年7月亳州市人民医院收治的70例系统性红斑狼疮患者,按照胸部CT检查显示是否存在淋巴结肿大将其分为淋巴结肿大组(35例,短径>10 mm)和非淋巴结肿大组(35例,短径<8 mm)。采集两组患者基线资料,检测实验室指标并进行对比,将上述指标中差异有统计学意义的因素纳入多因素logistic回归分析,筛选系统性红斑狼疮患者发生淋巴结肿大的危险因素,分析典型病例的影像学图像。结果:淋巴结肿大组患者关节炎的发生率高于非淋巴结肿大组,肾损害的发生率低于非淋巴结肿大组,差异有统计学意义(x^(2)=4.769、4.884,P<0.05);淋巴结肿大组患者抗核抗体(ANA)、抗ds-DNA抗体及抗Sm抗体阳性率均高于非淋巴结肿大组,差异有统计学意义(x^(2)=4.590、5.040、5.833,P<0.05),白细胞计数(WBC),补体C3和C4水平均低于非淋巴结肿大组,红细胞沉降率(ESR)、免疫球蛋白G(IgG)及系统性红斑狼疮疾病活动指数(SLEDAI)评分均高于非淋巴结肿大组,差异有统计学意义(t=28.179、20.791、26.192、16.173、41.142、10.057,P<0.05);logistic回归分析结果显示,补体C3、IgG及SLEDAI评分是系统性红斑狼疮患者发生淋巴结肿大的危险因素(OR=3.034、2.721、1.127,P<0.05),而年龄大、肾损害为保护因素(OR=0.259、0.254,P<0.05)。结论:淋巴结肿大的出现预示着患者的疾病进展的过程中发生多系统损害的风险较大,且病情活动度较为严重。Objective:To explore the assessment value of chest computed tomography(CT)for lymph node enlargement in systemic lupus erythematosus and the relationship of that with disease progression.Method:A total of 70 patients with systemic lupus erythematosus who admitted to The People's Hospital of Bozhou from July 2020 to July 2023 were selected.They were divided into lymph node enlargement group(35 cases,short diameter>10mm)and non-lymph node enlargement group(35 cases,short diameter<8mm)according to whether there was lymph node enlargement in CT examination for chest.The baseline data of two groups of patients were collected,and the indicators of laboratory detection were detected and compared.In the above indicators,the factors with statistically significance in differences were included in multivariate logistic regression analysis.The risk factors of occurring lymph node enlargement in patients with systemic lupus erythematosus were screened.And then,the imaging pictures of typical cases were analyzed.Results:The incidence of arthritis in patients of lymph node enlargement group was significantly higher than that of non-lymph node enlargement group,and the incidence of renal damage of former was significantly lower than that of non-lymph node enlargement group,with statistically significant differences(x^(2)=4.769,4.884,P<0.05).The positive rates of anti nuclear antibody(ANA),anti ds-DNA antibody and anti Sm antibody in patients of lymph node enlargement group were significantly higher than those of non-lymph node enlargement group(x^(2)=4.590,5.040,5.833,P<0.05),respectively.The white blood cell count(WBC),the levels of complement C3 and C4 of lymph node enlargement group were significantly lower than those of non-lymph node enlargement group,while the erythrocyte sedimentation rate(ESR),immunoglobulin G(IgG)and the scores of systemic lupus erythematosus disease activity index(SLEDAI)were significantly higher than those of the non-lymph node enlargement group,and the differences were statistically significant(2t=28

关 键 词：胸部CT 系统性红斑狼疮 淋巴结肿大 评估 疾病进程 

分 类 号：R814.42[医药卫生—影像医学与核医学]