Clinical Characteristics,Treatment And Follow-Up Analysis Of Liver Damage In Patients With Newly Diagnosed Systemic Lupus Erythematosus

Objective: To analyze the clinical and laboratory characteristics of patients with newly diagnosed systemic lupus erythematosus(SLE)complicated with liver damage and analyze the treatment and disease outcomes after treatment.Methods: A retrospective study was conducted on 458 patients with newly diagnosed SLE hospitalized in the Department of Rheumatology and Immunology of the First Affiliated Hospital of Bengbu Medical College from April 2012 to January2022.According to the liver function at the time of initial diagnosis(ALT,AST)were divided into liver injury group(Liver damage,LD),intermediate liver damage group(intermediate liver disease,i LD)and non-LD group,the clinical manifestations and laboratory results of liver damage group vs non-LD group,liver damage group vs intermediate liver damage group,non-liver damage group vs intermediate liver damage group,non-liver damage group vs liver damage group + intermediate liver damage group were compared and analyzed,and the treatment and treatment outcome of liver damage group were observed.Results: 1.458 Of the patients with SLE,41(9.0%)had liver damage,4 were male and 37 were female.The average age of onset was(34.2 ± 13.0)years.There were87 cases(19.0%)in the middle liver damage group,9 cases were male and 78 cases were female,the average age of onset was(36.8 ± 15.8)years.There were 330 patients(72.0%)with normal liver function,28 were male and 302 were female.The average age of onset was(36.3 ± 13.7)years.2.non-LD group vs LD group :The course of disease in LD group was shorter than that in non-LD group.The incidence of fever(>38.0 ℃),new rash,NPSLE,infection,anemia,leukopenia,thrombocytopenia,the positive rate of anti-SSB/La antibody and SLEDAI score in LD group were significantly higher than those in nonLD group.The incidence of arthritis,the level of complement C3 and serum albumin in LD group were lower than those in non-LD group.3.non-LD group vs i LD group: The i LD group had higher incidences of fever,infection,and thrombocytopenia than the non-LD group,and lower incidences of alopecia and arthritis,complement C3 levels,and serum albumin levels than the nonLD group.4.LD group vs i LD group : The incidence of new rash,alopecia,NPSLE,thrombocytopenia,positive rate of anti-SSA/Ro52 antibody and SLEDAI score in LD group were significantly higher than those in i LD group,and the level of complement C3 was significantly lower than that in i LD group.5.non-LD group vs LD+i LD group: The incidence of fever,fatigue,NPSLE,infection,anemia,leukopenia and thrombocytopenia in LD+i LD group was significantly higher than that in non-LD group,and the incidence of arthritis,complement C3 level and serum albumin level were lower than that in non-LD group.6.All the 41 SLE patients with liver damage were treated with glucocorticoid and liver protection drugs,and some patients were treated with gamma globulin and immunosuppressant.The liver transaminases of 33 cases were recovered to normal range within 1 year,only 1 case relapsedConclusion: 1.The clinical manifestations of liver damage in patients with SLE are mostly elevated liver transaminases,and rarely develop into end-stage liver disease.2.Patients with primary SLE liver damage have higher disease activity and are often associated with hematologic and neuropsychiatric involvement.3.After standard treatment,the liver function of SLE patients with liver damage recovered quickly,recurrence was less,and prognosis was relatively good.