摘要
目的探索不同住院结局SLE患者的临床特征并进行住院死亡相关性分析。方法由各参研单位根据统一方式收集病历资料,总结江苏省26家三甲医院1999—2009年1 611例首次住院SLE患者的临床资料,根据住院结局分为死亡组(91例)及对照组(1 520例),分析不同住院结局SLE患者临床表现及相关预测危险因素。组间计数资料比较采用χ2检验,正态定量资料比较采用成组t检验;非正态定量资料比较采用秩和检验;相关性研究采用Logistic回归分析。结果1 611例纳入研究的SLE患者中,死亡组91例(5.6%),对照组1 520例(94.4%)。死亡组病程(28(4,60)个月与12(2,47)个月,Z=-3.290,P<0.05)、男性占比(13.2%与7.1%,χ^2=4.606,P<0.05)、癫痫(8.8%与1.7%,χ^2=17.550,P<0.05)、精神症状(41.8%与23.8%,χ^2=14.809,P<0.05)、狼疮性头痛(19.8%与6.0%,χ^2=25.898,P<0.05)、脱发(47.3%与30.3%,χ^2=11.541,P<0.05)、心包炎(35.2%与22.0%,χ^2=8.408,P<0.05)、心肌炎(4.4%与1.0%,χ^2=5.885,P<0.05)、发热(55.0%与28.5%,χ^2=28.632,P<0.05)、血红蛋白下降(60.9%与44.8%,χ^2=8.603,P<0.05)、管型尿(24.2%与12.2%,χ^2=10.884,P<0.05)、血尿(51.7%与37.8%,χ^2=6.988,P<0.05)、肾小球滤过率(eGFR)下降(27.6%与11.0%,χ^2=18.122,P<0.05)、AST升高发生率(30.2%与17.9%,χ^2=8.176,P<0.05)较对照组高,对照组关节炎(34.3%与18.7%,χ^2=9.459,P<0.05)、蛋白尿(31.6%与14.3%,χ^2=12.169,P<0.05)、ESR升高(80.4%与71.8%,χ^2=4.192,P<0.05)、低补体发生率(44.2%与17.6%,χ^2=24.881,P<0.05)及抗dsDNA抗体阳性率(39.7%与23.1%,χ^2=9.963,P<0.05)较死亡组高。Logistic回归分析显示癫痫发作[OR=4.035,95%CI(1.338,12.164)]、狼疮性头痛[OR=3.026,95%CI(1.406,6.511)]血红蛋白下降[OR=2.116,95%CI(1.139,3.934),P<0.05]、eGFR下降[OR=2.159,95%CI(1.011,4.610),P<0.05]、发热[OR=2.567,95%CI(1.422,4.634),P<0.05]与SLE患者住院期间死亡呈正相关,ESR升高[OR=0.418,95%CI(0.218,0.802),P<0.05]、低补体[OR=0.328,95%CI(0.120,0.894),P<0.05]与其呈负相关。�
Objective To explore the clinical characteristics and prognostic indicators that classify patients with systemic lupus erythematosus (SLE) at risk of in-hospital mortality. Methods Medical records of 1611 SLE patients admitted between 1999-2009 were collected from 26 centers across Jiangsu province, and patients were divided into two groups based on the outcomes. The suspected risk factors of poor outcomes were selected and then analyzed by chi-square test, independent-samples t test, Wilcoxon rank sum test and Logistic regression. Results;Among the 1 611 enrolled patients, 91 patients were in the death group (5.6%) and 1 520 patients in the control group (94.4%). The duration of disease [28(4, 60) m vs 12(2, 47) m, Z=-3.290, P<0.05), the rate of male/female (13.2% vs 7.1%,χ^2=4.606, P<0.05), as well as the occurrence rateof seizure (8.8% vs 1.7%,χ^2=17.550, P<0.05), psychosis (41.8% vs 23.8%,χ^2=14.809, P<0.05), lupus headache (19.8% vs 6.0%,χ^2=25.898, P<0.05), alopecia (47.3% vs 30.3%,χ^2=11.541, P<0.05), pericarditis (35.2% vs 22.0%,χ^2=8.408, P<0.05), myocarditis (4.4% vs 1.0%,χ^2=5.885, P<0.05), fever (55.0% vs 28.5%,χ^2=28.632, P<0.05), decreased hemoglobin levels (60.9% vs 44.8%,χ^2=8.603, P<0.05), urinary casts (24.2% vs 12.2%,χ^2=10.884, P<0.05), hematuria (51.7% vs 37.8%,χ^2=6.988, P<0.05), decreased estimate glomerular filtration rate (eGFR) levels (27.6% vs 11.0%,χ^2=18.12, P<0.05), and elevated glutamic-oxaloacetic transaminase (AST) levels (30.2% vs 17.9%,χ^2=8.176, P<0.05) were higher in the death group. The frequency of arthritis (34.3% vs 18.7%,χ^2=9.459, P<0.05), proteinuria (31.6% vs 14.3%,χ^2=12.169, P<0.05), elevated erythrocyte sedimentation rate (ESR) levels (80.4% vs 71.8%,χ^2=4.192, P<0.05), decreased complement levels (44.2% vs 17.6%,χ^2=24.881, P<0.05) and anti-dsDNA antibodies positivity rate (39.7% vs 23.1%,χ^2=9.963, P<0.05) were higher in the control group. Logistic regression analysis showed seizure [OR=4.035, 95%CI(1.338, 12.164), P<0.05], lupus headache [OR=3.0
作者
刘婷
胥魏
陈海凤
袁风红
孙凌云
Liu Ting;Xu Wei;Chen Haifeng;Yuan Fenghong;Sun Lingyun(Department of Rheumatology and Immunology, the Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi 214023, China;Department of Rheumatology and Immunology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China)
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2019年第8期530-535,共6页
Chinese Journal of Rheumatology
基金
国家自然科学青年基金(81501345).
关键词
红斑狼疮
系统性
回顾性研究
死亡原因
疾病特征
Lupus erythematosus, systemic
Retrospective studies
Cause of death
Disease attributes
