Analysis Of The Sensitivity Indices To The Two Treatment Schemes Of Systemic Lupus Erythematosus

Objective: Conventional steroid therapy and pulse therapy (in combination with methylprednisolone and cyclophosphamide) were widely applied in the treatment of systemic lupus erythematosus (SLE). However, there is little data available of sensitivity indices that related with the response to the therapy. The aim of this study is to find out the sensitivity indices and the regression equations of the two regimens, which can be used to evaluate the efficacy of the two regimens. Methods: The clinical data of 111 cases who met the diagnosis criteria of SLE activity were analysed. All the cases were divided into two groups based on the SLEDAI and OUT score: patients with mildly to moderately active disease(groupl) and patients with highly active disease(groupll). The two groups were scored with SLEDAI and OUT before and after treatment, and the difference between the score before and after treatment was served as dependent variable(Y) and the difference between the activity indices before and after treatment was served as independent variable (X).Regression analysis was used to determine the sensitive indices and evaluate the efficacy of therapy.Result: In groupl, the sensitive index to conventional steroid therapy is erythrocyte sedimentation rate (ESR); and the sensitive indices to pulse therapy are white blood cell (WBC) and ESR. In groupll, the sensitive indices to conventional steroid therapy are rash, WBC, ESR and platelet(PLT); and those to pulse therapy are complement), WBC, ESR and PLT. In groupl and groupll, there is significant difference between the scores before and after treatment(P<0.01). In the high-grade activity group, there is significant difference of effect between the two regimens on hematuria and vasculitis (P<0.05).Conclusion: Each regimen has its own regression equation and sensitivity indices that can be used to evaluate the efficacy of the therapy. ESR is a sensitive index to each group. Conventional steroid therapy and pulse therapy are all effective to patients in groupl and in groupll. The treatment should be individulized in groupl. Pulse therapy is more effective than conventional steroid therapy for the patients with renal impairment and vasculitis in groupll.