Abstract:

Objective  To study the relationship between clinical features, laboratory-related indicators and prognosis of juvenile systemic lupus erythematosus(SLE).

Methods  A total of 145 juvenile patients with SLE were selected, and the incidence of poor prognosis was recorded. The clinical features and laboratory-related indicators of patients with different prognosis were compared. The independent influencing factors for the poor prognosis of juvenile SLE were analyzed by Cox risk model. According to the analysis results of Cox risk model, the prognostic index(PI) equation was established to analyze its value in evaluating the poor prognosis.

Results  They were followed up for 1-10 years, with the median follow-up of(5.85±2.67) years. Of them, 3 cases were lost to follow-up, 5 cases died and 32 cases experiened recurrence. In addition, 37 cases had poor prognosis, and the poor prognosis rate was 25.52%. The incidence of Raynaud's disease, pulmonary infection, vertigo and vomiting in the poor prognosis group was significantly higher than that in the control group. The levels of reliable bit cast(RBC), 24 h urinary protein, total cholesterol(Cho), immunoglobulin A(IgA) and erythrocyte sedimentation rate(ESR) in the poor prognosis group were significantly higher than those in the control group, while the levels of complement 3(C3) and complement 4(C4) were significantly lower than those in the control group(P＜0.05). Cox risk regression model analysis showed that Raynaud's disease(β=0.934, HR=2.545, 95%CI=1.228-5.274, P=0.012), neuropsychiatric systemic lupus erythematosus(NPSLE)(β=0.806，HR=2.239，95%CI=1.102-4.549，P=0.026), IgA(β=0.921, HR=2.512, 95%CI=1.403-4.498, P=0.002), 24 h urinary protein quantification(β=0.784, HR=2.191, 95%CI=1.132-4.241, P=0.020) and C3(β=-0.523, HR=0.593, 95%CI=0.402-0.875, P=0.008) were independent influencing factors for the poor prognosis of juvenile patients with SLE. PI equation was established according to Cox risk regression model. Receiver operating characteristic(ROC) curve analysis showed that the area under ROC curve(AUC) of PI equation to evaluate the adverse prognostic risk of juvenile patients with SLE was 0.784(SE=0.091, 95%CI=0.606-0.963, P=0.032), the sensitivity was 0.800 and the specificity was 0.737.

Conclusion  The prognosis of juvenile patients with SLE is related to its clinical features and laboratory-related indicators. The PI equation established accordingly has high accuracy in evaluating the poor prognosis of patients.

Key words:

lupus erythematosus, systemic, clinical features, laboratory-related indicators