儿童系统性红斑狼疮呼吸系统受累的临床特征和危险因素分析  

Clinical characteristics and risk factors of respiratory system involvement in children with systemic lupus erythematosus

作　　者：瞿宁 朱洪涛[1] Qu Ning;Zhu Hongtao(Department of Pediatrics,the First Afiliated Hospital of Xinjiang Medical University,Urumqi 841100,China)

机构地区：[1]新疆医科大学第一附属医院儿内三科,乌鲁木齐841100

出　　处：《中国小儿急救医学》2024年第12期905-909,共5页Chinese Pediatric Emergency Medicine

基　　金：新疆维吾尔自治区自然科学基金(2022D01C466)。

摘　　要：目的分析儿童系统性红斑狼疮(cSLE)呼吸系统受累的临床特征, 并探讨cSLE患儿出现呼吸系统受累的危险因素。方法选取2016年3月至2023年3月于新疆医科大学第一附属医院儿科首次住院的cSLE患儿为研究对象, 根据其是否有呼吸系统受累, 分为呼吸系统受累组和无呼吸系统受累组。比较两组之间的临床特征差异, 通过多因素Logistic回归模型分析cSLE呼吸系统受累的危险因素, 并绘制受试者工作特征(ROC)曲线评价其预测价值。结果共纳入152例cSLE患儿, 呼吸系统受累组58例(38.1%), 无呼吸系统受累组94例(61.8%)。与无呼吸系统受累组相比, 呼吸系统受累组患儿的发病年龄更大、系统性红斑狼疮疾病活动性指数更高, 出现发热、关节痛、心脏损害、血液系统损害的比例更大, 血红蛋白、血小板水平更低, 红细胞沉降率、C-反应蛋白水平更高, 抗dsDNA抗体阳性率更高, 差异均有统计学意义(均P<0.05)。多因素Logistic回归分析显示, 年龄大、心脏损害、血液系统损害、抗dsDNA抗体阳性为cSLE呼吸系统受累的独立危险因素(均P<0.05)。年龄、心脏损害、血液系统损害、抗dsDNA抗体的ROC曲线下面积分别为0.607、0.623、0.678、0.720, 4者联合后的曲线下面积为0.872, 灵敏度为88.3%, 特异度为70.7%。结论 cSLE患儿易出现呼吸系统受累, 如患儿起病年龄大、存在心脏或血液系统损害、抗dsDNA抗体阳性, 应注意呼吸系统受累可能, 需密切关注患儿的症状和体征, 积极完善相关检查, 及时诊断和治疗, 以改善预后。Objective To analyze the clinical characteristics of respiratory system involvement in children with systemic lupus erythematosus(SLE)and explore the risk factors associated with respiratory system involvement in cSLE.Methods The children with SLE who were hospitalized from March 2016 to March 2023 for the first time in the Department of Pediatrics at the First Affiliated Hospital of Xinjiang Medical University were selected as the research objects.According to whether had respiratory system involvement,they were divided into respiratory system involvement group and non-respiratory system involvement group.The differences of clinical characteristics between the two groups were compared.The risk factors of respiratory system involvement in children with SLE were analyzed by multivariate Logistic regression model,and the predictive value was evaluated by drawing the receiver operating characteristic(ROC)curve.Results A total of 152 pediatric patients with SLE were included,of which 58(38.1%)cases were in the respiratory system involvement group,and 94(61.8%)cases were in the non-respiratory system involvement group.Compared to the non-respiratory system involvement group,the respiratory system involvement group of pediatric patients with SLE had an older age when onset,a higher systemic lupus erythematosus disease activity index,higher proportions of fever,joint pain,cardiac involvement,and hematological involvement,lower levels of hemoglobin and platelets,higher erythrocyte sedimentation rate and C-reactive protein levels,and a higher positivity rate of anti-dsDNA antibodies.The differences were all statistically significant(P<0.05).Multivariable Logistic regression analysis showed that older age,cardiac involvement,hematological involvement,and positive anti-dsDNA antibodies were independent risk factors for respiratory system involvement in pediatric patients with SLE(P<0.05).The area under the ROC curves for age,cardiac involvement,hematological involvement,and positive anti-dsDNA antibodies were 0.607,0.623,0.

关 键 词：系统性红斑狼疮 儿童 呼吸系统 危险因素 

分 类 号：S15[农业科学—土壤学]