Analysis Of Clinical Features And Risk Factors In Patients With Systemic Lupus Erythematosus With Renal Damage

Objective:Through retrospective analysis of the clinical and pathological characteristics of patients with first-onset systemic lupus erythematosus(SLE)with or without renal damage,in order to explore the pathogenesis and related risk factors of renal damage in patients with lupus.Methods:Regression collection and recording of hospitalizations in the Department of Rheumatology and Immunology and Department of Nephrology of the First Hospital of Jilin University from March 20,2013 to January 20,2021 are in line with the 1997 American College of Rheumatology(ACR)revised systemic lupus erythematosus classification According to the standard clinical data of 196 patients,113 of them were patients with lupus nephritis diagnosed by renal biopsy for the first time.Divided into two groups according to whether there is kidney involvement: simple SLE group(83 cases),SLE renal damage group,namely lupus nephritis(LN)group(113 cases),among 113 cases of LN patients,according to whether there is abnormal renal function Divided into two groups: LN normal renal function group(67 cases),LN abnormal renal function group(46 cases).Collect statistics on the general conditions,clinical manifestations,laboratory indicators and pathological data of113 kidney biopsy patients at the onset of 196 patients.Use statistical methods to compare the clinical data between the groups from different angles.Analyze the different independent variables and perform multivariate regression analysis to identify risk factors for lupus.Result:A total of 196 SLE patients were enrolled in this study,of which 83 were SLE patients without renal disease and 113 were ln patients diagnosed by renal biopsy.Among 113 ln patients,67 had normal renal function and 46 had abnormal renal function.(1)The incidence of serositis,anemia,hematuria,and white blood cell urine in the LN group was higher,and the total cholesterol,triglyceride,and SLEDAI scores were higher,which was statistically different from the SLE group(P<0.05);The levels of globulin,serum albumin,leukopenia,C3,C4,and Ig G decreased,and the differences were statistically significant compared with the SLE group(P<0.05).When the score of kidney involvement in the SLEDAI score of the LN group was removed,the statistical analysis was performed again and compared with the SLE group,the difference was still statistically significant(P<0.05).(2)The incidence of serositis,anemia,and pathological crescent formation in the LN abnormal renal function group is higher,and the NLR,triglyceride,AI,and CI values are higher,which is statistically different from the LN normal renal function group Scientific significance(P<0.05);blood albumin is lower,and the difference is statistically significant compared with the LN normal renal function group(P<0.05).And male lupus patients are more prone to kidney damage,the difference between the two groups was statistically significant(P<0.05).(3)The statistically significant factors obtained through univariate analysis between the SLE group and the LN group were used as independent variables,and the Logistic multivariate analysis was performed.The hemorrhage albumin,serum globulin,total cholesterol,and SLEDAI scores were independent of renal damage in lupus patients.Risk factors(P<0.05).Draw the receiver operator characteristic curve(ROC)of independent influencing factors,in which the area under curve(AUC)of serum albumin is 0.878(P<0.001),and its prediction sensitivity is 90.4% The specificity is 76.1%;the area under the ROC curve of serum globulin is 0.714,its prediction sensitivity is 91.6%,and the specificity is 47.8%;the area under the ROC curve of total cholesterol is 0.810,and its prediction sensitivity is 70.8%.The SLEDAI score is 83.1%;the area under the ROC curve is 0.911,its prediction sensitivity is 81.4%,and the specificity is 88.0%.The univariate analysis between the LN renal function normal group and the LN renal function abnormal group obtained statistically significant factors as independent variables,and the Logistic multivariate analysis showed that male patients,AI,and CI were the causes of abnormal renal function in LN patients Independent risk factors(P<0.05).Draw a receiver operating characteristic curve for independent influencing factors,where the area under the ROC curve of AI is0.643,its predictive sensitivity is 39.1%,and its specificity is 88.1%;the area under the ROC curve of CI is 0.750,and its predictive sensitivity is 65.2 %,the specificity is 68.7%.Conclution:(1)LN patients are more prone to serositis,anemia,hematuria,leukopenia,hyperlipidemia,and high SLEDAI scores,while serum globulin,albumin,leukocytes,C3,C4,and Ig G are relatively low.Among them,serum globulin,blood Albumin,total cholesterol,and SLEDAI score are independent risk factors for renal damage in SLE patients.(2)Patients with LN renal dysfunction are more likely to have males,serositis,anemia,crescent formation,and high NLR,high blood lipids,high AI values,and high CI values,while serum albumin is relatively low.Among them,males,AI,CI It is an independent risk factor for abnormal renal function in patients with LN.