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中华临床实验室管理电子杂志 ›› 2019, Vol. 07 ›› Issue (04) : 203 -206. doi: 10.3877/cma.j.issn.2095-5820.2019.04.003

所属专题: 文献

实验研究

神经精神性狼疮患者实验室指标及临床症状研究
扎西曲宗1, 王鹭1, 黄卓春1, 胡静1, 李立新1, 项松1, 张乃丹2, 严冰3, 武永康1,()   
  1. 1. 610041 成都,四川大学华西医院实验医学科
    2. 618000,德阳市人民医院检验科
    3. 610041 成都,四川大学华西医院风湿免疫科
  • 收稿日期:2018-08-02 出版日期:2019-11-28
  • 通信作者: 武永康
  • 基金资助:
    四川省科技厅项目(项目编号2016JY0035); 四川省卫生厅项目(项目编号16PJ326,川干研2017-105)

Study on the laboratory indexes and clinical symptoms of patients with neuropsychiatric systemic lupus erythematosus

Dzong TrashiChhoe1, Lu Wang1, Zhuochun Huang1, Jing Hu1, Lixin Li1, Song Xiang1, Naidan Zhang2, Bing Yan3, Yongkang Wu1,()   

  1. 1. Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, China
    2. Department of Laboratory Medicine of Deyang People′s Hospital, Deyang 618000, China
    3. Department of Rheumatology, West China Hospital, Sichuan University, Chengdu 610041, China
  • Received:2018-08-02 Published:2019-11-28
  • Corresponding author: Yongkang Wu
  • About author:
    Corresponding author: Wu Yongkang, Email:
引用本文:

扎西曲宗, 王鹭, 黄卓春, 胡静, 李立新, 项松, 张乃丹, 严冰, 武永康. 神经精神性狼疮患者实验室指标及临床症状研究[J/OL]. 中华临床实验室管理电子杂志, 2019, 07(04): 203-206.

Dzong TrashiChhoe, Lu Wang, Zhuochun Huang, Jing Hu, Lixin Li, Song Xiang, Naidan Zhang, Bing Yan, Yongkang Wu. Study on the laboratory indexes and clinical symptoms of patients with neuropsychiatric systemic lupus erythematosus[J/OL]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2019, 07(04): 203-206.

目的

分析神经精神性红斑狼疮(neuropsychiatric systemic lupus erythematosus,NPSLE)患者的实验室指标和临床症状,为NPSLE患者的病情判断和个体化治疗提供依据。

方法

对确诊的136例NPSLE和146例非神经精神性系统性红斑狼疮(non-NPSLE)患者的相关实验室检测指标及临床症状进行对比分析。

结果

NPSLE组的C反应蛋白、中性粒细胞数、中性粒细胞比例及抗核抗体(antinuclear antibodies,ANA)、乙肝病毒DNA拷贝数高于non-NPSLE组(P<0.05);而血清白蛋白、红细胞沉降率、免疫球蛋白G、免疫球蛋白E、淋巴细胞数、淋巴细胞比例在NPSLE组低于non-NPSLE组(P<0.05)。NPSLE组患者系统性红斑狼疮疾病活动度评分(systemic lupus erythematosus disease activity index,SLEDAI)显著高于non-NPSLE组(P<0.05),除神经精神系统表现外,低补体(89.71%)、24h蛋白尿(59.50%)和发热(58.82%)等临床症状也较为常见。

结论

血清ANA阳性而淋巴细胞计数及比例降低与NPSLE患者活动度相关。乙肝病毒感染可能与NPSLE有关,在临床诊治中应予以重视。

Objective

To analyze the laboratory indexes and clinical symptoms of patients with neuropsychiatric systemic lupus erythematosus (NPSLE), so as to provide the basis for the condition judgment and individual treatment of NPSLE patients.

Methods

The laboratory indexes and clinical manifestations of 136 cases of NPSLE and 146 cases of non-NPSLE were compared and analyzed.

Results

The distribution of C-reactive protein, neutrophils, neutrophil rate, antinuclear antibodies (ANA) and hepatitis B virus DNA copies in NPSLE group were higher than those in non-NPSLE group (P<0.05), while the distribution of serum albumin, erythrocyte sedimentation rate, immune globulin G, and immune globulin E concentrations, lymphocytes and lymphocyte ratio were lower than those in non-NPSLE group (P<0.05). The systemic lupus erythematosus disease activity index (SLEDAI) score in NPSLE group was significantly higher than in that non-NPSLE group (P<0.05). In addition to the neuropsychological manifestations, the clinical symptoms of low complement (89.71%), 24 hours proteinuria (59.50%) and fever (58.82%) are also common in NPSLE group.

Conclusions

The activity of NPSLE patients was related to the decrease of lymphocyte count and proportion while ANA was positive in serum. Hepatitis B virus infection may be related to NPSLE, which should be paid more attention in clinical diagnosis and treatment.

表1 NPSLE和non-NPSLE实验室定量指标比较
表2 NPSLE和non-NPSLE实验室定性指标比较
表3 NPSLE和non-NPSLE临床症状比较分析
表4 系统性红斑狼疮疾病活动度评分比较
1
Nived O, Sturfelt G, Liang MH, et al. The ACR nomenclature for CNS lupus revisited[J]. Lupus, 2003,12(12):872-876.
2
武永康,黄卓春,石运莹,等. 中国四川一个系统性红斑狼疮家系蛋白指纹图谱的表达研究[J]. 四川大学学报医学版, 2009,40(3):504-507.
3
Wu XY, Yang M, Xie YS, et al. Causes of death in hospitalized patients with systemic lupus erythematosus: a 10-year multicenter nationwide Chinese cohort [J]. Clin Rheumatol, 2019,38(1):107-115.
4
Hanly JG, Urowitz MB, Sanchez-Guerrero J, et al. Neuropsychiatric events at the time of diagnosis of systemic lupus erythematosus: an international inception cohort study[J]. Arthritis Rheum, 2007,56(1):265-273.
5
Feng M, Lv J, Fu S, et al. Clinical features and mortality in Chinese with lupus nephritis and neuropsychiatric lupus: A 124-patient study[J]. J Res Med Sci, 2014,19(5):414-419.
6
Al-Obaidi M, Saunders D, Brown S, et al. Evaluation of magnetic resonance imaging abnormalities in juvenile onset neuropsychiatric systemic lupus erythematosus[J]. Clin Rheumatol, 2016,35(10):1-8.
7
Pisetsky DS, Lipsky PE. Role of antinuclear antibody determinations in classification criteria for systemic lupus erythematosus: comment on the article by leuchten et al[J]. Arthritis Care Res (Hoboken), 2019,71(5):696.
8
Wang M, Gladman DD, Ibañez D, et al. Long-term outcome of early neuropsychiatric events due to active disease in systemic lupus erythematosus[J]. Arthritis Care Res (Hoboken), 2012,64(6):833-837.
9
Groot N, Shaikhani D, Teng YKO, et al. Long-term clinical outcomes in a cohort of adults with childhood-onset Systemic Lupus Erythematosus[J]. Arthritis Rheumatol, 2019,71(2): 290-301.
10
Fanouriakis A, Boumpas DT, Bertsias GK. Pathogenesis and treatment of CNS lupus[J]. Curr Opin Rheumatol, 2013,25(5):577.
11
Bezalel S, Guri KM, Elbirt D, et al. Type I interferon signature in systemic lupus erythematosus[J]. Isr Med Assoc J, 2014,16(4):246-249.
12
Hanly JG. Diagnosis and management of neuropsychiatric SLE[J]. Nat Rev Rheumatol, 2014,10(6):338-347.
13
Yu XX, Yao CW, Tao JL, et al. The expression of renal Epstein-Barr virus markers in patients with lupus nephritis[J]. Experimental and therapeutic medicine, 2014, 7(5):1135-1140.
14
Fang J, Li W, Tan M, et al. Effect of different hepatitis B infection status on the prognosis of active lupus nephritis treated with immunosuppression: a retrospective analysis of 177 patients[J]. Int J Rheum Dis, 2018,21(5):1060-1067.
15
Liao HY, Tao CM, Su J. Concomitant systemic lupus erythematosus and HIV infection: A rare case report and literature review[J]. Medicine (Baltimore), 2017,96(51):e9337.
16
Elsenosy FM, Mousa SG, Mohamed NA, et al. Study of antichromatin antibodies as a marker of lupus activity and lupus nephritis[J]. Egypt J Immunol, 2018,25(1):113-124.
17
Magro-Checa C, Schaarenburg RA, Beaart HJ, et al. Complement levels and anti-C1q autoantibodies in patients with neuropsychiatric systemic lupus erythematosus[J]. Lupus, 2016,25(8):878.
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