Chinical Study Of 142 Patiens With Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is one kind of autoimmune diseases with chronic inflammation of unknown etiology and with the characteristics of obvious immunol disorder and multi-autoantibodies in the serum.Its clinical manifestation, course and prognosis are various which can invade any organ or system with multicombination and be quiescent and aggravate periodically. Young female patients are common and the ones at reproductive age are 90%~95%, children and the elder can also be involved. ObjectiveOur retrospective clinical study of in-patients with SLE is going to explore the clinical and epidemiologic characteristics of SLE. We assess the utility of measurement of laboratory parameters in the diagnosis, evaluating the disease activity and the reaction to therapy. In our study, we are also investigate the changs of T-cell subsets on peripheral blood, the situation of organ damage, infectious complication and osteoporosis complication in SLE. So we can establish deep conception on the truth of the diease and guide the clinical therapy in order to improve the prognosis. Methods:Retrospective investigation 142 cases of SLE from January 2001 to January 2005 were admitted to our department. Register the data of the age, sex, clinical manifestation of onset, duration of the disease, the situation of system damage, the chang of T-cell subsets on peripheral blood, infection complication and osteoporosis complication in SLE. Draw a correlation conclusion with statistical analysis. Results:1. General situation: The study cohort comprised 130 female and 12 patients, the M:F ratio was 1:10.83. The avarge age was 35.9 ± 20.5 years. The avarge mean follow-up was 40.5 ± 12.6 months. The female patients in 20-40 years are commonest. Its frequence was 54.2%.2. Clinical features: The oncet manifestation was athritis or arthritic ache, its frequence was 50.0%. The cumulative frequencies of organic involvement were: renal 45.0% was in the first place, cardial-vascular 28.9%, lunged 27.5%, haematological 26.8%, hepatic 8.4%, splenic 7.0% and neurological 7.0%.3. Laboratory data: The positive frequence of ANA was 97.9%;Camparied with the patients with inactive-stage, the positive percentage of serum anti-dsDNA and high level of serum IgG and low level of WBC, PLT and complment C3 in the patients with active-stage had significant difference (P<0.01).4. The expression of CD3, CD4 immune cells was down-regulated in SLE, while that of CD8 was up-regulated, CD4/CD8 was down-regulated.5. The situation of SLE complicated infection: The total number of the patients with complicated infection was 35 in 142. Its percentage was 28.2%.6. The situation of SLE complication osteoporosis: 69 in the total number of the patients with complicated osteoporosis was 21, its percentage was 30.4%.7. Glucocorticoid is the the best curative therapy strategis: The total number of the patients with glucocorticoid was 140, its percentage was 98.6%.Conclusion:1. The female at reproductive age are commonest in patients with SLE.2. Arthritis or arthritic ache which is the important onset manifastation in patients with SLE is the primary symptoms of most patients.3. The most important organ damage is kidney, followed by heart, lung and hematology dysfunction.4. The combination detection of ANA, anti-dsDNA and anti-ENA has important clinical value for SLE diagnosis, therapy and prognosis. Serum anti-dsDNA, IgG, complmentC3, WBC and PLT are the significant features of disease activity in patients with SLE. These markers also can evaluate the reaction to therapy.5. The expressions of T-cell subsets on peripheral blood are abnormal in SLE patients,especially in active stage of disease and patients with lupus nephritis.6. The patients with SLE in older group are prone to infection compared with the younger group. Lower ALB, therapy with antibiotic within 2 weeks before infection, therapy with high-dose and long-term glucocorticoid or immuno-suppressant raise the opportunity for infection in patients with SLE.7. Timely and appropriate therapy with appropriate glucocorticoid and aggressive precaution and control of organ failure and quick control of disease activity can improve the prognosis of osteoporosis complicatied in SLE.8. The therapy strategy including dose and period of treatment should not be machine-made. We should give individual therapy to get the best curative effect and least side effect according to the different person, different age and different condition.