摘要
【目的】从中医“湿邪”角度探讨狼疮性肾炎(lupus nephritis,LN)的复发危险因素,分析湿邪与LN复发的关系。【方法】回顾性收集2012年7月1日至2020年12月31日广东省中医院风湿科病房收治的病程超过2年的72例LN患者的病历资料。根据湿邪评分分级情况将患者分为无湿组(湿邪评分分级为0级者)17例和有湿组(湿邪评分分级为1级及以上者)55例。采用卡方检验分析不同湿邪评分分级患者的复发情况,筛选与复发相关的临床差异指标,并进一步采用Logistic回归分析探讨LN复发的相关危险因素。【结果】(1)复发情况:纳入研究的72例LN患者中,湿邪评分≥70分者复发率[69.09%(38/55)]明显高于湿邪评分<70分者[5.88%(1/17)],组间比较,差异有统计学意义(P<0.01)。(2)单因素分析结果显示:LN病程>3年、基线期有发热症状、红细胞沉降率(ESR)>50 mm/h、纤维蛋白原(FIB)>3.5 g/L、湿邪证素评分≥70分的两组间比较,差异均有统计学意义(P<0.05或P<0.01),其余因素的两组间比较,差异均无统计学意义(P>0.05)。(3)Logistic回归分析结果显示:LN病程>3年(OR=15.915,95%CI:2.739~92.463)、基线期有无发热症状(OR=36.231,95%CI:2.811~466.961)、ESR>50 mm/h(OR=7.997,95%CI:1.360~47.018)、湿邪证素评分≥70分(OR=65.201,95%CI:5.586~761.035)是LN复发的独立危险因素,差异均有统计学意义(P<0.05或P<0.01)。【结论】湿邪程度与LN复发相关,湿邪可能是LN复发的独立危险因素之一,值得临床关注和进一步的深入研究。
Objective To explore the risk factors for the recurrence of lupus nephritis(LN)from the perspective of“pathogenic damp”in Chinese medicine,and to analyze the relationship between pathogenic damp and the recurrence of LN.Methods The clinical symptoms and laboratory findings of 72 patients with LN(course of disease≥2 years)admitted in rheumatology ward of Guangdong Provincial Hospital of Traditional Chinese medicine(the Second Affiliated Hospital of Guangzhou University of Chinese Medicine)from July 1,2012 to December 31,2020 were retrospectively analyzed.The patients were divided dampness-free group(17 cases,with the grading of pathogenic damp scores being grade zero)and dampness group(55 cases,with the grading of pathogenic damp scores being or over grade one).The chi-square test was used to analyze the recurrence of LN with various grading of pathogenic damp,and then the recurrence-related clinical indicators were screened.Furthermore,the risk factors were analyzed via multivariate Logistic regression.Results(1)Among the 72 LN patients,the recurrence rate of the patients with the pathogenic damp scores≥70(38/55,69.09%)was significantly higher than that of those with the pathogenic damp scores<70(1/17,5.88%),and the intergroup comparison showed that the difference was statistically significant(P<0.01).(2)The results of univariate analysis showed that there were statistically significant differences(P<0.05 or P<0.01)in the pairwise comparison of the duration of LN disease>3 years,fever symptoms at baseline,erythrocyte sedimentation rate(ESR)>50 mm/h,fibrinogen(FIB)>3.5 g/L,and pathogenic damp scores≥70.However,no statistically significant differences were shown in the pairwise comparison of the other factors(P>0.05).(3)Logistic regression analysis showed that the duration of LN disease>3 years(OR=15.915,95%CI:2.739~92.463),the presence or absence of fever symptoms at baseline(OR=36.231,95%CI:2.811~466.961),ESR>50 mm/h(OR=7.997,95%CI:1.360~47.018),and pathogenic damp syndrome scores≥70(OR=65.201,95%CI:5
作者
何晓红
晏菁遥
黄清春
周颖燕
HE Xiao-Hong;YANJing-Yao;HUANG Qing-Chun;ZHOU Ying-Yan(Dept.of Rheumatology,the Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510006 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2023年第1期9-14,共6页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
中医湿证国家重点实验室专项(编号:SZ2022ZZ13)
广东省中医院中医药科学技术研究专项(编号:YN2019QL19)。
