系统性红斑狼疮合并血小板减少危险因素Logistic回归分析

[摘要] 目的 分析系统性红斑狼疮（SLE）合并血小板减少危险因素。 方法 采用回顾性研究方法，对85例系统性红斑狼疮合并血小板减少相关因素进行多因素非条件Logistic回归分析，并血小板减少的住院患者进行回顾性分析，以同期住院的无血小板减少的SLE患者作为对照，探讨血小板减少的危险因素。 结果 85例SLE住院患者，出现血小板减少者有24例，占28.24%，其中14例出现轻度血小板减少，6例出现中度血小板减少，4例为重度血小板减少。SLE患者合并浆膜炎、血液系统受累、ACA阳性及脾大者易出现血小板减少。血小板减少组肾脏损害的发生率高于血小板正常患者，但蝶形红斑的发生率低于后者，差异均有统计学意义（P < 0.05）。 结论 SLE患者合并浆膜炎、血液系统受累、ACA阳性及脾大者易出现血小板减少。

[关键词] 系统性红斑狼疮；血小板减少；危险因素；分析

[中图分类号] R593.24+1 [文献标识码] A [文章编号] 1674-4721（2012）07（b）-0039-03

The risk factors Logistic regression analysis of systemic lupus erythematosus combine with thrombocytopenia

ZHONG Ruiqiong LUO Weiyan

Department of Nephrology, Gaozhou People's Hospital in Guangdong Province, Gaozhou 525200, China

[Abstract] Objective To analyze the risk factors of systemic lupus erythematosus combine with thrombocytopenia. Methods The associated factors of 85 cases of systemic lupus erythematosus combined with thrombocytopenia were retrospectively studied by non-conditional Logistic regression analysis. Patients with thrombocytopenia were analyzed retrospectively and compared with SLE patients who had not thrombocytopenia in the same period, risk factors for thrombocytopenia were analyzed. Results In 85 cases of hospitalized patients with SLE, there were 24 cases of thrombocytopenia, accounted for 28.24%, including 14 cases of mild thrombocytopenia, 6 patients of moderate thrombocytopenia, 4 cases of severe thrombocytopenia. SLE patients who supervened with serositis, hematologic involvement, ACA positive and splenomegaly were likely to have thrombocytopenia. Thrombocytopenia kidney damage rate was higher than that of patients with normal platelet, but butterfly erythema occur rate was lower than that of the latter, the difference was statistically significant(P < 0.05). Conclusion SLE patients who supervened with serositis, hematologic involvement, ACA positive and splenomegaly are likely to have thrombocytopenia.

[Key words] Systemic lupus erythematosus; Thrombocytopenia; Risk factors; Analysis

系统性红斑狼疮是一种累及多系统和多器官的疾病。目前其发病机制尚不明确，可能与患者自身的抗体、狼疮活动度等有关[1-2]。目前国外的部分学者对85例系统性红斑狼疮（SLE）合并血小板减少患者和143例无血小板减少的患者进行了回顾性研究，结果发现C3的降低是血小板减少的危险因素之一[3]。有资料显示系统性红斑狼疮合并血小板减少的患者比血小板正常的患者容易出现肺部疾病和肾脏病变以及血液系统受累[4]，而蝶形红斑却不容易出现。血小板的主要功能是止血，血小板轻度减少时会引起皮肤出现瘀点或瘀斑，但严重减少时就会导致内脏出血。由于多种原因，可能会导致误诊，为了探讨系统性红斑狼疮合并血小板减少危险因素，笔者对本科85例SLE患者的临床资料进行对比分析。现报道如下：

1 资料与方法

1.1 一般资料

2009年1月～2011年12月广东省高州市人民医院肾内科确诊的SLE住院患者共85例，因SLE疾病本身导致的血小板减少24例，发生率为28．24％，其中重度血小板减少4例（4．70％），中度血小板减少14例（16.48％），轻度血小板减少6例（7.06％）。病例组中男性10例，女性14例，男:女=5:7，年龄22～45岁，平均（33.6±10.8）岁。在同期无血小板减少的SLE住院患者中，选取性别、年龄、病程相匹配的24例作为对照组。