To Find Out Risk Factors Of Systemic Lupus Erythematosus Complicated With Carotid Atherosclerosis And Its Relationship With B Cell Activating Factor

Objective:To understand the risk factors of Carotid Atherosclerosis（CAS）in patients with systemic lupus erythematosus（SLE）;To explore the relationship between CAS and B-cell activation factor（BAFF）in SLE patients,and provide reference for clinical prevention and treatment of Atherosclerosis（AS）in SLE patients.Method:1.A total of 200 SLE patients who met the inclusion criteria and were admitted to our department from October 2019 to May 2021 were included.The Carotid artery color Doppler imaging results showed that Carotid Atherosclerosis/ Carotid intima-meida thickness（CAS/CIMT）was found in group A,A total of 75 cases;125 cases without carotid plaque formation and/or intimal thickening（NO-CAS /CIMT）were included in group B.2.General data collection:The age,gender,course of lupus disease,clinical manifestations（skin lesions,Raynaud’s phenomenon,joint swelling and pain,etc.）and past history of all subjects were recorded at admission.The degree of disease activity was calculated based on the Systemic Lupus erythematosus disease Activity Index 2000（SLEDAI2K）.3.Laboratory tests: Initial blood routine,urine routine,liver function,kidney function,blood lipid profile,serum C-reactive Protein（CRP）,Erythrocyte sedimentation rate（RST）on admission were collected.ESR)and serum immunoglobulin（Ig A,Ig M,Ig G）,complement（C3,C4）,ANA and anti-DSDNA quantitative detection results.4.Color Doppler ultrasonography of carotid artery was performed by special personnel assigned by the ultrasound examination department according to relevant operating procedures.The clinical data of CAS/CIMT group（group A）and NO-CAS/CIMT group（group B）were compared and the risk factors of SLE combined with CAS/CIMT were analyzed.5.To explore the relationship between SLE combined with CAS and BAFF.（1）Under the condition of excluding the traditional ass formation of traditional susceptibility to AS formation,such as smoking history,high BMI,and family history of cardiovascular disease,103 of the 200 cases enrolled in the above-mentioned groups were continuously and randomly selected,including the combined CAS group（group I,32 cases）,the CIMT group（group II,31 cases）and the no-CAS/CIMT group（group III,40 cases）.Serum specimens of healthy people（group IV,40 cases）who met the conditions were selected as the control group.Enzyme-linked immunosorbent assay（ELISA）was used to detect serum baff levels in 103 patients and 40 healthy control groups using enzyme-linked immunosorbent assay（ELISA）.（2）Whether there were statistical differences in the expression of BAFF in SLE and healthy control groups.（3）Whether there were differences in the expression of BAFF in SLE combined with CAS between groups I,II and III,and through correlation analysis,the correlation between BAFF and SLE disease-related indicators commonly used in clinical practice（such as C3,SLEDAI2 K,etc.）was understood..Result:1.A one-factor analysis of the clinical manifestations,laboratory indicators,drug application history and other indicators collected in A and B groups found that there were statistical differences between the two groups of age,SLE course,butterfly erythema and other common skin lesions,decreased glomerular filtration rate,low C3 level,high anti-ds DNA level quantification,high triglyceride（TG）,ESR abnormality,high D-2 polymer,whether the history of hydroxychloroquine,and SLEDAI2 K score index were standardized（P <0.05）.2.The non-conditional binary logistic analysis of the above univariate factor analysis showed that there was a statistical difference in the history of age,C3 level,high TG,SLEDAI2 K score,and standardized application of hydroxychloroquine in the two groups,which was an independent risk or protection factor for patients with SLE who were prone to combine CAS/CIMT（P < 0.05）.3.The serum BAFF level was analyzed and found that the serum BAFF expression in the SLE group was significantly higher than that in the healthy control group（P<0.05）.Comparing the expression levels of BAFF in the serum of groups I,II and III,it was found that the expression of BAFF in group I was significantly higher than that in groups II and III（P < 0.05）.Through correlation analysis,serum BAFF was positively correlated with age,ESR,serum Ig A and serum Ig G levels and SLEDAI2 K scores in the SLE group（P <0.05）and inversely correlated with serum complement C3 levels（r =-0.309,P<0.05）.Conclusion:1.The occurrence of CAS/CIMT in SLE patients,in addition to age,high TG and other traditional risk factors prone to CAS/CIMT,serum C3 level and SLE disease activity（SLEDAI2K）are related to the occurrence of CAS/CIMT in SLE patients;2.Age,serum C3,high TG and SLEDAI2 K were risk factors for THE occurrence of CAS/CIMT in SLE patients,and BAFF level had a certain relationship with the occurrence of CAS in SLE patients;3.In addition to paying attention to traditional risk factors,early diagnosis,early treatment and timely control of disease activity and increase of C3 levels can prevent or delay the occurrence and development of CAS/CIMT in patients with SLE;the standardized application of hydroxychloroquine is conducive to the prevention and treatment of CAS/CIMT in patients with SLE;targeted therapy for BAFF may be conducive to preventing CAS from occurring in SLE.