系统性红斑狼疮患者活动性发热特点及相关性分析
계통성홍반랑창환자활동성발열특점급상관성분석
Clinical features and correlation research of fever in systemic lupus erythematosus patients
  • 万方数据
    中华风湿病学杂志 중화풍습병학잡지
    CHINESE JOURNAL OF RHEUMATOLOGY
    2011年 10期 666-670 ,共5页

    袁风红%孙凌云%潘文友%王向党%潘解萍%张缪佳%张育%谭魁麟%李晶%陈志伟%丁翔%钱先%达展云%陶娟%王美美%邹耀红

    원풍홍%손릉운%반문우%왕향당%반해평%장무가%장육%담괴린%리정%진지위%정상%전선%체전운%도연%왕미미%추요홍

    红斑狼疮,系统性%发热%危险因素%回顾性研究 紅斑狼瘡,繫統性%髮熱%危險因素%迴顧性研究
    홍반랑창,계통성%발열%위험인소%회고성연구
    Lupus erythematosus,systemic%Fever%Risk factor%Retrospective studies
    目的 探讨系统性红斑狼疮(SLE)患者活动性发热的临床特点并进行相关性分析.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1999-2009年住院SLE患者的临床资料及治疗情况,分析发热与SLE的临床表现、免疫学指标、疾病活动及治疗情况间的关系.组间的计数资料比较采用x2检验,非正态分布的计量资料比较采用秩和检验,相关性分析采用Logistic回归分析.结果 1762例SLE患者纳入研究范围,其中活动性发热患者729例,非发热患者1033例,通过对照研究,发热组入院年龄、是否初治、光敏感、浆膜炎、神经精神系统累及、肝脾淋巴结肿大、血白细胞、血红蛋白、红细胞沉降率(ESR)、C反应蛋白(CRP)、丙氨酸转氨酶(ALT)、白蛋白、血清肌酐、补体C3、抗双链DNA (dsDNA)抗体、抗Sm抗体、SLE疾病活动指数(SLEDAI)评分、既往治疗与非发热组比较差异有统计学意义(尸＜0.05)；Logistic回归分析显示血白细胞异常[比值比(OR)=1.396,95％可信区间(CI)1.114～1.711,P=0.004]、CRP (OR=1.005,95％CI 1.002～1.009,P=0.002)、ALT( OR=1.003,95％CI 1.001 ～1.005,P=0.005)、血清肌酐(OR=0.997,95％CI 0.995～0.999,P=0.007)、血红蛋白(OR=0.986,95％CI0.981～0.992,P=0.000)、入院年龄(OR=0.984,95％CI 0.974～0.993,P=0.001)及环磷酰胺应用比例(OR=0.557,95％CI 0.382～0.813,P=0.002)与SLE 患者发热相关.结论 发热是SLE常见的临床表现之一.血白细胞下降、CRP升高、肝功能异常、贫血、入院年龄轻为SLE患者出现发热症状的危险因素,而肾累及、环磷酰胺应用为保护因素.
    목적 탐토계통성홍반랑창(SLE)환자활동성발열적림상특점병진행상관성분석.방법 유각삼연단위근거통일방식수집병력자료,총결강소성1999-2009년주원SLE환자적림상자료급치료정황,분석발열여SLE적림상표현、면역학지표、질병활동급치료정황간적관계.조간적계수자료비교채용x2검험,비정태분포적계량자료비교채용질화검험,상관성분석채용Logistic회귀분석.결과 1762례SLE환자납입연구범위,기중활동성발열환자729례,비발열환자1033례,통과대조연구,발열조입원년령、시부초치、광민감、장막염、신경정신계통루급、간비림파결종대、혈백세포、혈홍단백、홍세포침강솔(ESR)、C반응단백(CRP)、병안산전안매(ALT)、백단백、혈청기항、보체C3、항쌍련DNA (dsDNA)항체、항Sm항체、SLE질병활동지수(SLEDAI)평분、기왕치료여비발열조비교차이유통계학의의(시＜0.05)；Logistic회귀분석현시혈백세포이상[비치비(OR)=1.396,95％가신구간(CI)1.114～1.711,P=0.004]、CRP (OR=1.005,95％CI 1.002～1.009,P=0.002)、ALT( OR=1.003,95％CI 1.001 ～1.005,P=0.005)、혈청기항(OR=0.997,95％CI 0.995～0.999,P=0.007)、혈홍단백(OR=0.986,95％CI0.981～0.992,P=0.000)、입원년령(OR=0.984,95％CI 0.974～0.993,P=0.001)급배린선알응용비례(OR=0.557,95％CI 0.382～0.813,P=0.002)여SLE 환자발열상관.결론 발열시SLE상견적림상표현지일.혈백세포하강、CRP승고、간공능이상、빈혈、입원년령경위SLE환자출현발열증상적위험인소,이신루급、배린선알응용위보호인소.
    Objective To investigate the clinical features of systemic lupus erythematosus (SLE) patients with fever and find out the related factors.Methods Data was collected by the same methods in the past ten years in fifteen hospitals in Jiangsu province and then the data were retrospectively analyzed.The potentially possible risk factors of fever in SLE were selected and then analyzed by chi-square test,Wilcoxon rank sum test and Logistic regression analysis.Results All 1762 patients were investigated.Seven hundred and twenty-nine had active fever.Age at hospitalization,initially treated patients,photosensitivity,serositis,nervous system involvement,generalized lymphadenopathy/hepatosplenomegaly,white blood cell count (WBC),haemoglobin (HB),erythrocyte sedimentation rate (ESR),C-reaction protein (CRP),alanine aminotransferase (ALT),albumin (ALB),serum creatinine (Scr),complement C3,anti-dsDNA antibodies positive rate,anti-Sm antibodies positive rate,SLEDAI score and past therapies were factors associated with SLE fever.Logistic regression analysis showed that abnormal WBC count (OR=1.396,95％CI 1.114-1.711,P=0.004),CRP(OR=1.005,95％CI 1.002-1.009,P=0.002),ALT(OR=1.003,95％CI 1.001-1.005,P=0.005),Scr (OR=0.997,95％CI0.995-0.999,P=0.007),HB (OR=0.986,95％CI 0.981-0.992,P=0.000),age (OR =0.984,95％ CI 0.974-0.993,P=0.001 ) and past usage of cyclophosphamide (CTX) (OR =0.557,95％CI 0.382-0.813,P=0.002) were correlated with SLE fever.Conclusion Fever is one of the most common clinical manifestations of SLE patients.Leucopenia,elevated CRP levels,liver function abnormalities,anemia,younger age are risk factors for SLE fever,while renal impairment and past usage of CTX are protective factors.
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