摘要
目的探讨导致系统性红斑狼疮住院患者死亡的影响因素。方法选取2014年9月至2019年9月于陕西省铜川市人民医院接受治疗的328例系统性红斑狼疮住院患者为研究对象,按照随访结果患者是否死亡分为对照组(296例)和死亡组(32例)。收集患者入院第2天的临床资料,收集两组患者实验室指标,并统计实验室指标异常率。具有统计学意义的相关因素纳入多因素Logistic回归分析。结果死亡组癫痫发作、神经精神症状、视觉障碍、关节炎、心包炎、脱发、狼疮性头痛、心肌炎、发热发生率明显高于对照组,差异有统计学意义(P<0.05)。死亡组估算肾小球滤过率(eGFR)下降、血红蛋白水平降低、天门冬氨酸氨基转移酶(AST)水平升高、管型尿、血尿、eGFR降低发生率明显高于对照组,差异有统计学意义(P<0.05);死亡组蛋白尿的发生率低于对照组,差异有统计学意义(P<0.05)。多因素分析结果显示,eGFR下降、血红蛋白水平降低、发热、狼疮性头痛、癫痫发作是影响住院红斑狼疮患者死亡的独立危险因素(P<0.05)。结论eGFR下降、血红蛋白水平降低、发热、狼疮性头痛、癫痫发作是影响住院红斑狼疮患者死亡的独立危险因素,临床医师在治疗住院红斑狼疮患者时应该重点关注上述因素。
Objective To explore the influencing factors that cause death in hospitalized patients with lupus erythematosus.Methods A total of 328 hospitalized patients with lupus erythematosus who were treated in People′s Hospital of Tongchuan from September 2014 to September 2019 were selected as the research objects.The patients were divided into the control group(296 cases)and the death group(32 cases)according to whether the patients died.On the second day of admission,the clinical data of the patients were collected,the laboratory index levels of the two groups were collected,and the abnormal rate of laboratory indexes was collected.Statistically significant related factors were included in multivariate logistic regression analysis.Results The incidence rates of seizures,mental symptoms,visual impairment,arthritis,pericarditis,hair loss,lupus headache,myocarditis and fever in the death group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The abnormal rates of decreased hemoglobin,increased AST,cast urine,hematuria,and decreased estimated Glomerular Filtration Rate(eGFR)in the death group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05).The incidence rate of proteinuria in the death group was lower than that in the control group,and the difference was statistically significant(P<0.05).Multivariate analysis showed that decreased eGFR,decreased hemoglobin,fever,lupus headache and seizures were independent risk factors affecting the death of hospitalized patients with lupus erythematosus(P<0.05).Conclusion Decreased eGFR,decreased hemoglobin,fever,lupus headache and seizures are independent risk factors affecting the death of hospitalized lupus erythematosus patients.Clinicians should pay attention to these factors when treating hospitalized lupus erythematosus patients.
作者
刘欢
阎岩
LIU Huan;YAN Yan(Department of Rheumatology,People′s Hospital of Tongchuan,Tongchuan,Shaanxi 727000,China;College of Life Sciences,Yan′an University,Yan′an,Shaanxi 716000,China)
出处
《检验医学与临床》
CAS
2020年第17期2482-2484,共3页
Laboratory Medicine and Clinic
关键词
系统性红斑狼疮
死亡
住院
相关因素
lupus erythematosus
death
hospitalization
related factors
