| Systemic lupus erythematosus (SLE), autoimmune mediated immune inflammation by outstanding performance of diffuse connective tissue disease. Serum antinuclear antibody appears to represent a variety of autoantibodies and multi-system involvement are the two main clinical features of SLE. The course of disease, diverse clinical manifestations and prognosis in order to periodically rest and increase the distinctive features, and a variety of combinations of forms of violations of an organ or system. Current research suggests that genetic and environmental factors for the onset and progression of systemic lupus erythematosus the more important factors, but its etiology is unclear and specific pathogenesis. SLE occurs in women of reproductive age. SLE disease susceptibility gene based on its existence, SLE disease central link for their own state of impaired immune tolerance, self-reactive polyclonal proliferation of lymphocytes and the appearance of autoantibodies. Over the years, to carry out effective early diagnosis of this disease and treatment on the continuous development and improvement of the prognosis of systemic lupus erythematosus have a more marked improvement.Objective:This set of experiments on 318 clinical cases of patients with systemic lupus erythematosus a systematic retrospective analysis, intended to study the clinical features of SLE, assessment-related projects for the laboratory diagnosis to determine the degree of disease activity's significance. And to study the SLE patients with major organ damage and cause of death situation. So that we will be more in-depth understanding of the pathogenesis of SLE, clinical characteristics, treatment options for the selection of patients treatment assessment and prognosis of patients with a certain significance. Methods:Retrospective survey from January 1, 2004 to July 2010 30 patients diagnosed with systemic lupus erythematosus, their gender, age, age of first onset, duration, initial symptoms, laboratory indicators, renal biopsy pathological conditions and causes of death and other items such as registration, application of statistical methods to a conclusion.Results:1.Demographic details: The study cohort comprised 286 female and 32 male patients,the F:M ratio was 8.9:1.The avarge age was 34.28±15.57 years old.The number of the patients with active-stage was 228,the number of the patients with inactive-stage was 90.2.Clinical features:The oncet manifestation was fever of 167 cases.It's frequence was 52.6%. Second, the high admission in patients with mainly mucocutaneous symptoms of abnormal fatigue, joint pain, swelling, urinary tract disorders.3.Cases involving important organs in patients with SLE and LN in patients with renal pathology(1)SLE patients with renal impairment were a total of 187 cases, involving the rate of 58.81%.(2)Pathological types of the largest number of typeⅣLN. And male and female SLE patients mainly as typeⅣlupus nephritis. Male and female patients with LN distribution of the pathology was no significant difference Renal pathology in this group showed that male patients with LN-andⅣ+ⅤⅤtype proportion is higher than the proportion of female patients with LN.(3)Patients with lupus nephritis showed occult nephritis accounted for 11.90%, more common inⅡ,Ⅲtype LN. Performance of nephritic syndrome accounted for 25.40%,,Ⅱ,Ⅲtype mainly nephritic syndrome, were 41.67%, 58.33%. Nephrotic syndrome accounted for 62.70%,Ⅳ,Ⅴ,Ⅲ+Ⅴ,Ⅳ+Ⅴ type mainly as nephrotic syndrome. The incidence of renal dysfunction type was 27.78%, more common inⅣ,Ⅳ+Ⅴtype LN.4.Laboratory data:(1)Patients with active serum anti double-stranded DNA (dsDNA) antibodies was higher than the inactive group, the statistical test was statistically significant(P<0.01).(2)Activities of the group of white blood cells (WBC) reduced, platelet (PLT) reduced, C3 decreased in patients with elevated immunoglobulin IgG is higher than the inactive group,it was statistically significant by statistical tests. Active and inactive C-reactive protein (CRP) increased in patients with reduced C4 complement the statistical analysis the ratio was no significant difference (P> 0.05).(3)In this set of data, the anti-SSA antibody, anti U1RNP antibody, anti-histone antibody positive rates were 32.08% ,45.91%, 27.6%, 21.07%. The statistical test in the four active and inactive groups was not significant between groups (P> 0.05).5.Cause of death in SLE patients in this group the main infection. Death in patients with infection and died as a direct result of 8 cases, accounting for 42.11%. Organ damage caused by the death to kidney damage and central nervous system damage common.Conclusion:1.Women of childbearing age is the SLE-prone groups.2. The more common clinical manifestations of SLE fever starting mucosa and skin abnormalities. Fever of unknown origin is an important clinical manifestations of SLE, SLE in clinical practice as fever of unknown origin should be an important differential diagnosis content.3.SLE patients with kidney damage important organs involved in the first place share.LN pathological types the most common typeⅣ.Ⅱ,Ⅲtype LN mainly as nephritis.Ⅳ,Ⅴ,Ⅲ+Ⅴ,Ⅳ+Ⅴtype LN mainly as nephritic syndrome.4. Can be applied in clinical WBC, PLT, IgG, complement C3 and anti ds-DNA antibodies on SLE disease activity in these tests to judge whether or not, and can be used as an important indicator of treatment response assessment.5.Infection as leading cause of death in patients with SLE, in the course of treatment to strengthen the effective control of infection. SLE patients also should pay attention to associated with kidney, central nervous system, cardiovascular system, the case of damage to the prevention and control.
|
PDF Full Text Request