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Clinical Characteristics And Related Risk Factors Of Cumulative Organ Damage In Systemic Lupus Erythematosus

Posted on:2024-04-24Degree:MasterType:Thesis
Country:ChinaCandidate:R P WangFull Text:PDF
GTID:2544307085978339Subject:Dermatology and venereology
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Objective:To retrospectively study the clinical characteristics and associated risk factors of cumulative organ damage in systemic lupus erythematosus.Methods:Clinical data of all patients were retrospectively collected which were in the First Affiliated Hospital of Xinjiang Medical University from Dec.2018 to Dec.2021,and cumulative organ damage were evaluated by SLICC/ACR damage index(SDI score).Patients with SDI≥1were defined as cumulative organ damage group(n=120),and else were defined as no-damage group(n=81),the clinical characteristics and related risk factors of organ damage were analyzed.Results:(1)The age,gender,ethnicity,disease duration,body mass index,and recurrence rates between two groups shows no significant difference(P>0.05);(2)In cumulative organ damage group,proteinuria≥3.5g/24h occured in 44 patients(36.67%),pulmonary hypertension occured in 37 patients(30.83%)and 36 patients(30.00%)showed aseptic bone necrosis;(3)There were significant differences between two groups in age of onset,education level,the proportion of high-dose prednisone treatment,cyclophosphamide treatment,white blood cell count,neutrophil count,red blood cell count,red blood cell distribution width,red blood cell distribution width/albumin ratio,hemoglobin/red blood cell distribution width ratio,24-hour urine protein content,urea,creatinine,triglyceride,serum albumin,plasma D2 polymer,cytomegalovirus antibody lg M,ratio of helper/induced T lymphocytes(CD4+T lymphocytes),ratio of suppressor/induced T lymphocytes(CD8+T lymphocytes)and SLEDAI score(P<0.05);(4)Multivariate logistic regression analysis showed that the independent risk factors of cumulative organ damagewere high-dose prednisone treatment,the distribution width of red blood cells,triglycerides and plasma D2 polymer,which illustrates the regression equation could be described as:Logit P(cumulative organ damage)=-12.548+(2.062*high-dose prednisonetreatment)+(0.208*erythrocytehemoglobindistribution width)+(1.063*triglyceride)+(0.002*plasma D2 polymer).The AUC is 0.834(95%CI:0.767-0.901),showed good model differentiation.Chi-Square Goodness-of-Fit Test showed good model calibration(X2=2.57,P=0.58).Conclusion:(1)There is no significant differences in age,gender,ethnicity,disease duration,body mass index and other baseline difference between two groups;Patients with late onset age,low education level,high proportion of treatment with high-dose prednisone or cyclophosphamide,and high disease activity had a high probability of cumulative organ damage;(2)In this case,the cumulative common damaged organs of SLE occurs in the urinary,respiratory and musculoskeletal systems,and the common forms of injury are urinary protein≥3.5g/24h,pulmonary hypertension and aseptic bone necrosis;(3)High levels of red blood cell distribution width,triglycerides,plasma D2 aggregates,and high-dose prednisone treatment are independent risk factors for SLE cumulative organ damage.The prediction model constructed in this study has a good discrimination and calibration degree.
Keywords/Search Tags:systemic lupus erythematosus, cumulative organ damage, SDI score, risk factors, predictive model
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