摘要
目的探讨儿童幼年系统性红斑狼疮（JSLE）合并特应质对其病情及预后的影响。方法收集2005年10月至2015年4月上海交通大学医学院附属仁济医院儿科确诊的JSLE60例，通过混合性队列研究的方法，将JSLE分为特应质组（26例）和非特应质组（34例）；记录2组患儿入组时临床及实验室相关资料和随访过程中病情评估指标、治疗药物以及病情预后等资料，通过数据统计和分析，比较2组之间各指标的差异。结果1．在起病初期，特应质组系统性红斑狼疮疾病活动性指数（SLEDAI）评分[（17．080±5．628）分比（12．590±4．856）分]、抗双链DNA（ds—DNA）抗体滴度[（62．590±43．602）IU／mL比（40．230±30．189）IU／mL]、红细胞沉降率[（59．150±40．315）mm／1h比（40．350±31．865）mm／1h]均明显高于非特应质组（P均〈0．05），而补体C3[（0．450±0．218）g/L比（0．640±0．333）g/L]、C4[（0．047±0．024）g/L比（0．116±0．172）g／L]均低于非特应质组（P均〈0．05）。2．随访1个月、6个月、1年，JSLE特应质组SLEDAI评分均高于非特应质组（P均〈0．05）。3．特应质组所需糖皮质激素日平均累积剂量大于非特应质组，使用免疫抑制剂种类多于非特应质组（P〈0．05）。4．在1年随访期间，特应质组病情复发次数及达到病情稳定时间均高于非特应质组（P〈0．05）。结论儿童JSLE合并特应质可能对其病情及预后产生不利影响。
Objective To evaluate the influence of atopy on the prognosis of juvenile -onset systemic lupus erythematosus （JSLE）. Methods The study was performed on 60 cases with JSLE diagnosed at the Department of Pediatrics, Renji Hospital Affiliated to School of Medicine of Shanghai Jiaotong University from October 2005 to April 2015. These patients were enrolled by mixed cohort study and subdivided into atopic group （26 cases） or nonatopic group（34 cases）. The clinical and laboratory data of the disease onset, disease assessment scores, medications during follow - ups and remission/flare of the disease were recorded and analyzed to compare the difference between 2 groups. Results （ 1 ） The systemic lupus erythematosus disease activity index （SLEDAI） score [ （ 17. 080 ±5. 628 ） scores vs （ 12.590 ± 4.856） scores ], anti - double - stranded DNA （ anti - dsDNA） [ （62. 590± 43. 602） 1U/mL vs （40. 230± 30. 189） IU/mL], erythrocyte sedimentation rate （ESR） [ （59. 150 ± 40. 315 ） mm/1 h vs （40. 350 ± 31. 865 ） mm/1 hi were significantly elevated at onset in the atopic group compared with non -atopic controls （all P 〈 0.05 ） , while the complement C3[ （0.450±0.218） g/L vs（0. 640±0. 333） g/L] ,C4[ （0.047±0.024） g/L vs（0. 116± 0. 172） g/L] in atopie group was lower than those in the nonatopic group （all P 〈0.05）. （2）During the followups of 1 and 6 months to 1 year,the JSLE patients with atopy always had higher SLEDAI score compared with the non - atopic controls（ all P 〈 0.05 ）. （ 3 ） For medications ,the daily cumulative glucocortieoid dose received by patients in the atopic group were larger than that of the non - atopic group, and the number of immunosuppressive agents used in the atopic group was more than that in the non - atopic controls （ P 〈 0.05 ）. （4） During the 1 - year follow - up, the rate of disease relapse in the atopic group was higher than that in the non - atopic group and the atopic group also needed much more time to reach disease remission （ P 〈 0.05 ）. Conclusion JSLE patients combined with atopy may have an adverse influence on the prognosis of JSLE.
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2016年第16期1248-1251,共4页
Chinese Journal of Applied Clinical Pediatrics
基金
上海市中医药事业发展三年行动计划重大研究项目（ZYSNXD-CC-ZDYJ030）
关键词
特应质
幼年系统性红斑狼疮
预后
Atopy
Juvenile - onset systemic lupus erythematosus ： Prognosis
