Analysis Of Related Factors Of Blood System Involvement In Patients With Primary Sjogren’s Syndrome

Background: Sjogren’s Syndrome,as a common connective tissue disease,can show many glands besides dryness,including blood system,respiratory system,urinary system and so on.The blood cells decrease is common in sjogren’s syndrome patients whose blood system is involved.Leukocytopenia will reduce the anti-infection ability,anemia caused by the decrease of red blood cells can lead to organ hypoxia and ischemia,and even critical conditions such as bleeding of important organs may occur,which will affect the prognosis of patients.Objective:The data of 260 patients with primary Sjogren’s syndrome hospitalized in the Department of Rheumatology and Immunology of the Second Affiliated Hospital of Dalian Medical University were collected for retrospective analysis to explore the related factors of primary Sjogren’s syndrome blood system involvement.Methods: A total of 260 pSS patients hospitalized in the Department of Rheumatology and Immunology of our hospital from April 2017 to November 2020 were selected and divided into two groups according to whether there was blood system involvement(Group A)and no blood system involvement(Group B).(1)General data(2)Complications(3)Clinical symptoms(4)Laboratory examination(5)Pathological results of lip gland and Schirmer test(5)System damage were compared between the two groups.The patients in group A were divided into leukopenia group(A Ⅰ),anemia group(A Ⅱ)and thrombocytopenia group(A Ⅲ).The data of group AⅠ,group A Ⅱ and group A Ⅲ were compared with those of group B to analyze the related factors of blood system involvement in primary Sjogren’s syndrome.Results:1.The average age of patients with primary Sjogren’s syndrome is 49 years old,which is more common in women.The incidence of leukopenia is the highest in pSS patients with blood system injury.The occurrence of Reynolds phenomenon in pSS with blood system involvement is higher than that without blood system injury(P=0.039),and that in pSS with leukopenia is higher than that without blood system injury(P=0.027),but there is no significant difference in disease course,sex,age of onset,clinical features and other factors among the groups.2.Hypertension,autoimmune thyroiditis,hypertriglyceridemia,diabetes mellitus,hypercholesterolemia,pulmonary interstitial lesions,renal involvement and autoimmune liver diseases have no correlation with the blood system involvement of pSS patients.3.There is no correlation between pSS blood system involvement and C-reactive protein and erythrocyte sedimentation rate.4.Compared with pSS without blood system involvement,pSS with blood system involvement has higher globulin level(P=0.032),ANA(P=0.032),anti-SSA antibody(P=0.011)and anti-SSB antibody positive rate(P=0.017).Compared with pSS without leukopenia,pSS with leukopenia has higher positive rate of anti-SSA antibody(P=0.02)and anti-SSB antibody(P=0.009).Compared with pSS group without hemoglobin reduction,pSS group with hemoglobin reduction has lower albumin(P=0.005)and prealbumin(P=0.032),higher globulin(P=0.001),and higher positive rate of anti-SSA antibody(P=0.049)and anti-SSB antibody(P=0.004).5.Reynolds phenomenon is an independent risk factor for blood system involvement and leukopenia in pSS patients(OR values are3.091 and 3.020,respectively),and high globulin level is an independent risk factor for hemoglobin reduction in pSS patients(OR=3.020).Conclusion:ANA-positive,anti-SSA antibody-positive,anti-SSB antibody-positive,Raynaud’s phenomenon and high serum globulin level are related to the blood system involvement of pSS patients,and Raynaud’s phenomenon is an independent risk factor(OR=3.091).Positive anti-SSA antibody,anti-SSB antibody and Reynolds phenomenon are related to leukopenia in pSS patients,and Reynolds phenomenon is an independent risk factor for leukopenia(OR=3.020).High positive rate of anti-SSA antibody and anti-SSB antibody,low levels of prealbumin and albumin,and high level of serum globulin are related to anemia in pSS patients,and the increase of globulin level is an independent risk factor for anemia(OR=1.052).