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目的探讨神经精神狼疮(NPSLE)发病的危险因素。方法对49例NPSLE患者及107例无神经系统病变的狼疮患者进行回顾性分析,先将研究变量做单因素分析,再将有意义的变量进行多因素非条件Logistic回归分析。结果单因素分析显示起病年龄、入选年龄、病程、蝶形红斑、发热、抗Sm抗体、抗核糖体P蛋白抗体、补体C3下降(<400mg/L)与NPSLE发病显著相关(P<0.05);而正规使用激素及免疫抑制剂是具统计学意义的保护因素(P<0.05)。进一步行多因素Logistic回归分析,结果显示,发热(OR=5.865)、抗Sm抗体阳性(OR=5.156)与NPSLE发病呈正相关,有统计学意义(P<0.05);而起病年龄(OR=0.848)、病程(OR=0.959)及正规使用激素(OR=0.052)与NPSLE发病呈负相关(P<0.05)。结论起病年龄小、病程短、发热、抗Sm抗体阳性是发生NPSLE的重要因素,而正规使用糖皮质激素和免疫抑制剂是NPSLE的保护因素,医生应关注NPSLE发生的危险因素,早期给予积极治疗。
Objective To explore the risk factors of neuropsychiatric lupus (NPSLE). Methods A retrospective analysis was performed on 49 patients with NPSLE and 107 patients with lupus without neurological disease. Univariate analysis of the study variables and multivariate non-conditional logistic regression analysis of significant variables were performed. Results Univariate analysis showed that onset age, age, course of disease, butterfly erythema, fever, anti-Sm antibody, anti-ribosomal protein P antibody and decreased complement C3 (<400mg / L) were significantly associated with the incidence of NPSLE (P < ; While regular use of hormones and immunosuppressive agents were statistically significant protective factors (P <0.05). Further multivariate Logistic regression analysis showed that fever (OR = 5.865), anti-Sm antibody positive (OR = 5.156) were positively correlated with the incidence of NPSLE (P <0.05) 0.848). The course of disease (OR = 0.959) and the regular use of hormones (OR = 0.052) were negatively correlated with the incidence of NPSLE (P <0.05). Conclusions The onset age, short course, fever and anti-Sm antibody positive are important factors for the occurrence of NPSLE. However, regular use of glucocorticoids and immunosuppressive agents is the protective factor of NPSLE. Doctors should pay attention to the risk factors of NPSLE and be positive treatment.