Analysis Of Influencing Factors That Affect The Outcome Of Systemic Lupus Erythematosus With Pulmonary Artery Hypertension

Objective:This thesis is to explore the main factors affecting the therapeutic effe ct of systemic lupus erythematosus patients with pulmonary arterial hypertension,and to provide reference and help for clinical treatment.Methods:Forty-three patients with systemic lupus erythematosus complicated wit h pulmonary arterial hypertension were retrospectively analyzed.Patients in study we re divided into effective group and ineffective group according to the degree of pulmo nary arterial systolic pressure declined after treatment.The detailed clinical data of th e two groups were collected.SPSS 20.0 software was used for statistical analysis.The results were assessed for the causes of different treatment responses.Results:1.There were 43 patients in this study.The age distribution of the patien ts was 25 to 40 years old,mainly female patients(male to female ratio 4: 39),22 pati ents were effective and 21 patients were ineffective.The total effective rate was 51.16%(22 / 43).2.Univariate analysis showed:(1)general situation: there was no statist ical difference in PASP,cardiac function classification,sledai score and SLE severity classification between the two groups before treatment(p > 0.05);(2)combined sym ptoms: there was no statistical difference between the two groups in the aspects of inte rstitial pneumonia,metabolic abnormalities(abnormal blood lipid and uric acid level),vasculitis,arthritis,proteinuria,rash,alopecia,Renault phenomenon and serous cav ity effusion(p > 0.05),and there was statistical difference in the aspects of combined fever and pericardial effusion(p< 0.05).(3)laboratory indicators: there was no signi ficant difference in neutrophil,lymphocyte,platelet count,plasma fibrinogen,comple ment C3,complement C4,erythrocyte sedimentation rate,CRP,antinuclear antibody,ds-dna,sm antibody,u1-RNP antibody,phospholipid antibody and histocyte antibod y between the two groups(p > 0.05).There was significant difference in plasma d-2 aggregate level and anti SSA antibody titer between the two groups(p< 0.01).(4)medication: there was no statistical difference between the two groups in the use of gl ucocorticoids,hydroxychloroquine,other immunosuppressants(mycophenolate mofetil / mycophenolate mofetil / azathioprine),globulin,vasodilators(CCB / ACEI / pro stacyclin / no / bosentan / sildenafil),anticoagulant drugs(low molecular weight hep arin / warfarin),antiplatelet drugs(aspirin / clopidogrel / dipyridamole),thrombolyti c drugs(lumbrokinase / urokinase),human albumin,diuretics(furosemide / bumeta nide,etc.)(p > 0.05).There was statistical difference in the use of cyclophosphamid e(p< 0.05).3.Logistic regression analysis showed that d-2 polymer level was an in dependent prognostic factor for SLE-PAH patients(p < 0.05).Conclusion:1.In this study,the total effective rate of SLE patients with PAH wa s 51.16 %;2.Treatment effects of SLE-PAH patients with high disease activity were better than that of SLE-PAH patients with low disease activity.3.The high titer of a nti-SSA antibody suggested the poor prognosis of SLE-PAH;4.D-2 polymer leve l is an independent risk factor for prognosis in SLE-PAH patients.Anticoagulant the rapy may be considered in patients with d-2 polymer level > 1 ug / ml.