| Objective:To collect and analyze the clinical data and laboratory examination characteristics of patients with systemic lupus erythematosus(SLE)recurrence in the Second Affiliated Hospital of Kunming Medical University,to explore the predisposing factors of patients with SLE recurrence,and improve the recognition of SLE recurrence,and provide a clinical basis for effectively reducing the recurrence of SLE patients,ti,ely diagnosis of recurrence and improving the prognosis of patients.Method:We collected SLE patients who had been followed up from July 2017 to January 2019 and met SLE classification standard revised by American College of Rheumatology in 1997.We screened the patients with relapse in the course of disease.Through detailed inquiry and query the relevant clinical data analysis of its incidence,age,gender,course of disease,morbidity,recurrence incentives,clinical manifestation and laboratory examination of relapse were analyzed.So as to summarize the causes of disease recurrence and suggest diseases Characteristic clinical and laboratory indicators of recurrence.Result:1.Demographic data:From July 2017 to January 2019,the dermatology department of the Second Affiliated Hospital of Kunming Medical University had confirmed 312 SLE patients,including 280 females and 32 males,male:female=1:8.75,aged 9-77 years old.The average was 37.70±14.18 years old,and the course of disease was 1-39 years,with an average of 9.11±6,18 years.Among them,123 patients had a total of 178 recurrences,114 females and 9 males.The gender of the patients with recurrence and the total follow-up were chi-square,p=0.167>0.05,the difference was not statistically significant.2.Possible causes of recurrence:Among the 178 patients who had recurrence during the course of the disease,about 42 patients(24.87%)were affected by poor compliance.Among them,32 cases(68.09%)were discontinued hormones,10 cases(21.28%)were irregularly taken hormones,5 cases(10.63%)were excessively reduced hormones,16 cases(8.47%)were reduced hormones,34 cases(17.99%)were tired,20 cases(10.58%)were sunbathed and 18 cases(9.52%)were infected.There were 15 pregnancies(7.94%),12 mental factors(6.35%),6 drugs(3.17%),3 operations(1.59%),2 traumas(1.06%),2 diets(1.06%)and 14 unknown(7.40%).Among them,there were 2 or more inducements(5.06%).3.SLEDAI score of relapsed patients:Mild activity5-9 points:139 person-times(78.09%),moderate activity10-14 points:35 person-times(19.66%),severe activity more than 15 points:4person-times(2.25%).Most patients with relapsed mild disease Activities are predominant.4.ROC curve indicates the relationship between clinical symptoms and recurrence diagnosis of SLE patients:fatigue,fever,arthralgia,rash,alopecia,mucosal ulcer and systemic edema have statistical significance for SLE recurrence,AUC>0.5,while headache and diarrhea have no statistical significance for SLE recurrence diagnosis,AUC=0.5.5.ROC curve indicates the relationship between laboratory indicators and recurrence diagnosis in SLE patients:proteinuria and hematuria,decrease of C3C4,decrease of WBC and PLT,increase of ds-DNA have diagnostic significance for recurrence of SLE patients.AUC>0.5.The increase of ANA and CRP and the decrease of Hb have no statistical significance for recurrence diagnosis of SLE patients,AUC=0.5.6.The AUC values of the combined clinical and laboratory indicators of relapsed patients are higher than the single-item valuesConclusion:1.The number of female SLE patients are significantly higher than that of male,and gender has no effect on the recurrence of SLE.2.The predisposing factors of SLE recurrence were poor patient compliance(self-stop,reduction and irregular intake of hormones),fatigue,sunshine and infection,followed by pregnancy,psychiatric factors,drugs,etc.However,some patients had unknown causes of recurrence.3.In the course of the disease,the clinical symptoms of rash,fever and fatigue are more significant in evaluating the recurrence of SLE than those of arthralgia,alopecia and systemic edema,while headache and diarrhea have no statistical significance in diagnosing the recurrence of SLE.4.Laboratory examination showed that positive proteinuria,decreased complement C3 and positive ds-DNA antibody were more signifieant in evaluating SLE relapse than that of complement C4,WBC,PLT,hematuria,ANA,CRP and Hb.There was no significant difference in diagnosing SLE relapse.5.Combined detection of clinical symptoms and laboratory indicators can improve the accuracy of SLE recurrence diagnosis. |
PDF Full Text Request