Correlation Between Immuno-biochemical Indexes And Clinical Manifestations And Disease Activity In Patients With SLE

Objective(s):To study the clinical manifestations and immunological indexes of active and inactive patients with systemic lupus erythematosus(SLE),and to explore the correlation between the immunological indexes and the clinical manifestations in patients with systemic lupus erythematosus(SLE).To provide evidence for diagnosis,treatment and prognosis of systemic lupus erythematosus.Methods:Selection in December 2013 to June 2018 with SLE into the second affiliated hospital of kunming medical university Department of Dermatology and venereal Diseases of 215 cases of patients,according to SLEDAI score were divided into activity group(SLEDAI score≥ 5)and inactive group(SLEDAI score 0-4 was inactive).The test results and statistical analysis in the form of immunological.indexes and clinical manifestations measurement data to mean±standard deviation(χ±S),said the count data expressed as a percentage(%),comparison between groups by Chi-square test,independent samples t-test,analysis of variance or nonparametric test,with P<0.05 for the difference was statistically significant.Results:Of the 215 SLE patients,28 were males and 187 were females,with a ratio of 1:6.68.The average age of the patients was 38.82 ± 15.68 years old.In this study,the blood system(71.16%)was the most frequently involved organ in SLE patients,followed by the skin(61.86%),the kidney(51.16%)and the liver(32.5%),Serous cavity(29.7%),joint(23.72%),neuropsychiatric system(17.67%),lung(4.65%).The incidence of discoid erythema(33.49%)was the highest in patients with skin involvement.The incidence of discoid erythema(33.4%)in patients with specific skin involvement was higher than rush erythema(16.3%).The incidence of nonspecific cutaneous mucosal involvement was as follows:alopecia(22.79%),photosensitivity(9.3%),oral ulcer(5.58%),vasculitis(5.58%)and Renault’s phenomenon(5.12%).In this study,there was a significant difference in TSH,FT4 between active and inactive patients(P<0.05).Manifested as the increase of TSH and the decrease of FT4.Anti-dsDNA antibody was correlated with sex,alopecia,oral ulcers,neuropsychiatric symptoms,serosa involvement,anemia,proteinuria,erythrocytic urine,tubular urine(P<0.05),and positively correlated with SLEDAI score(r=3.250,P<0.000).Anti-dsDNA antibody positive may be accompanied by other immunological and biochemical abnormalities,including antinuclear antibody,anti-histone antibody,anti-nucleosome antibody,ARPA,serum IgG increased,complement C3 decreased,complement C4 decreased,ALB,Urea,UA,TG.ARPA was associated with age,discoid erythema,sphenoid erythema,arthritis,photosensitivity,alopecia,anemia,proteinuria,red blood cell urine,tubular urine,but not correlated with SLEDAI score.ARPA positive may be accompanied by other immunological and biochemical abnormalities,Including antinuclear antibody,anti-dsDNA antibody,anti-RNP antibody,anti-Sm antibody,anti-SSA antibody,anti-nucleosome antibody,serum IgG increased,complement C3 decreased,complement C4 decreased.The incidence of oral ulcer,serositis and anemia in renal injury group was significantly higher than that in negative group(P<0.05),and anti-dsDNA antibody and complement C4 were correlated with renal injury(P<0.05).Age was negatively correlated with SLEDAI score(r=0.064,P=0.016),complement C3 was negatively correlated with SLEDAI score(r=13.109,P=0.000).Conclusion(s):The most common organ and system involved in systemic lupus erythematosus is the blood system,followed by the skin and kidney.The incidence of discoid erythema in the skin involvement is the highest in the patients with systemic lupus erythematosus.The incidence of liver injury and thyroid dysfunction in active patients with SLE disease is higher than that in inactive patients.Active treatment of primary diseases may be beneficial to liver injury and thyroid function.Anti-dsDNA antibodies were associated with renal injury,alopecia,oral ulcers,neuropsychiatric symptoms,serositis,anemia,and negatively correlated with SLEDAI scores.The higher the titers of anti-dsDNA antibodies,the higher the lupus activity indexs.ARPA was associated with proteinuria,urinary of red blood cell type,tubular urine,discoid erythema,sphenoid erythema,alopecia,photosensitivity and arthritis.There was no correlation between ARPA and SLEDAI score.There was a negative correlation between age and SLEDAI score in patients with SLE,which suggested that the younger the patients were,the higher the disease activity indexs were.There was a negative correlation between complement C3 and SLEDAI score.The lower complement C3 was,the higher the disease activity indexs were.In patients with SLE,patients with negative anti-dsDNA and ARPA were less likely to suffer from renal injury.