Risk Factors Analysis And Risk Assessment Model Of Adult Systemic Lupus Erythematosus With Digestive System Symptoms

Objective: To study the clinical characteristics and risk factors of adult systemic lupus erythematosus with digestive system manifestations and generate a preliminary risk assessment model.Then,to provide reference for diagnosis and prevention of the disease.Methods: We retrospectively collected 307 patients of SLE diagnosed in the first and second affiliated Hospital of Guangxi Medical University from August 2012 to August 2017,and clinical datas were systematically analyzed,especially focus on the patients with digestive system manifestations.Results: There were 61 patients(19.9%)with digestive system manifestations,of which 29 cases(47.5%)appeared as the initinal symptoms of SLE.Abdominal pain was the most common in 31 patients(50.8%),followed by23 patients(37.7%)had nausea and vomiting and diarrhea occured in 18 cases(29.5%).Compared with the control group,the SLE patients with digestive system manifestations were older and had longer hospital stays.And the incidence of blood system damage,polyserositis and pyeloureterectasis in SLE patients with digestive system manifestations were higher than those without,the difference was statistically significant(P<0.05).In addition,decreased ALB、C3 or PLT and increased CRP、ALT、AST、ALP、GGT were also associated with digestive system manifestations of SLE patients,the difference was statistically significant(P<0.05).Multivariate logistic regression analysis showed that blood system damage,polyserositis,decreased ALB and elevated ALT were independent predictors for digestive system manifestations: hematological system injury,polyserositis and elevated ALT were the risk factors,whereas elevated ALB was the protect factor.According to Logistic analysis,the regression model was established initially and calculating Youden index.Then,the Y value corresponding to the maximum Youden index was selected as the optimal critical point,and Y = 0.233 was determined.The prediction ability of the constructed risk assessment model was studied and it was found that the prediction specificity of the model was 92.1%,the sensitivity was 70.0%,and the overall accuracy was 87.5%.Conclusion: Digestive system symptom is a common clinical manifestation of SLE.The patients of SLE with digestive system symptom are older and stay in hospital longer,various clinical and imaging manifestations.As independent risk factors,blood system damage,polyserositis,decrease of ALB and elevation of ALT can be used to establish a preliminary risk assessment model for SLE complicated with digestive system symptoms.