| Objective:By analyzing the general situation,clinical manifestations,laboratory examinations,treatment methods and influencing factors of sixty systemic lupus erythematosus(SLE)patients,we discussed the early diagnosis,reasons of misdiagnosis,pathogenesis,clinical features and the clinical data before and after the treatment.It could help to strengthen the awareness of pathogenesis,clinical manifestations and treatment.To provide theoretical basis for improving the ability of clinical diagnosis and treatment of this disease and improve the prognosis and quality of life of patients.Methods:Sixty patients diagnosed with SLE for the first time were selected from department of dermatology of Wannan Medical College affiliated Yijishan Hospital from January 2012 to December 2017.The clinical mucocutaneous manifestations,disease activity,laboratory examinations and glucocorticoid therapy were reviewed retrospectively in 60 patients.Some of the data were divided into non-elderly group(<50 years old)and elderly group(≥50 years old)according to age and then analyzed between the two groups.Statistical analysis was performed using SPSS 19.0 statistical software.Results:The sex ratio of male to female was 1:11 of 60 patients included in the study.The ages were 13 to 66 years old,with peak incidence of ages range from 20 to 29 years.Among the 60 patients,49 patients(81.67%)had the facial butterfly erythema as the first clinical manifestation,followed by 42 cases(70%)of vasculitis and 33 cases(55%)of joint swelling.The most commonly involved systems are urinary system,digestive system,respiratory system and cardiovascular system.Before the treatment,white blood cell(WBC)count decreased in 20 patients(33.33%),hemoglobin(HGB)decreased in25 patients(41.67%)and platelet count(PLT)decreased in 10 patients(16.67%).The average of WBC count,HGB and PLT count of 60 patients were 5.10±2.68×10~9/L,110±18.10g/L and 147.22±60.23×10~9/L respectively before the treatment.After the treatment,the average of WBC count,HGB and PLT count of 60 patients were7.51±2.7×10~9/L,116.8±16.85g/L and 181.75±62.26×10~9/L respectively which were higher than before and there had statistically differences before and after the treatment.The ESR of the 49 patients(81.67%)increased before the treatment.What’s more,the average ESR of 60 patients was 36.82±23.22mm/h decreased to 13.84±10.81mm/h after the treatment.The difference was statistically significant.Before the treatment,C3decreased in 45 patients(75%)and C4 decreased in 36 patients(60%).The average of C3 and C4 in 60 patients were 0.71±0.32g/L and 0.10±0.04g/L respectively.After the treatment,C3 and C4 were 0.81±0.33g/L and 0.13±0.08g/L respectively.The differences were statistically significant.The uric acid of the 60 patients was decreased from 249.61±73.75 umol/L to 220.86±86.14 umol/L,and the difference was statistically significant.24 patients(40%)increased in the 24-hour urinary protein quantification before the treatment.And the average 24-hour urinary protein quantification decreased from 1.16±0.64g/L to 0.51±0.30g/L.There had statistically significant difference before and after the treatment.The prevalence of anti-Sm antibody and anti-SSA antibody in patients with SLE less than 50 years old were higher than that in SLE patients older than 50 years.However,the differences of positive rate of anti-nuclear antibodies,anti ds-DNA antibodies and anti-SSB antibodies were not statistically significant.Of the 60 patients,15 patients(25%)received glucocorticoid and immunosuppressive treatment,19 patients(31.67%)received glucocorticoid and hydroxychloroquine treatment and the rest 26 patients(43.33%)received glucocorticoid and immunosuppression and hydroxychloroquine treatment.Patients outcomes were obviously effective(13 cases,21.67%),effective(40 cases,66.67%)and ineffective(7cases,11.67%).The SLEDAI score of all the sixty patients decreased from 9.58±3.38before the treatment to 5.55±2.51 after the treatment,and the difference was statistically significant.Conclusion:?Patients with systemic lupus erythematosus were mainly young adults,women were significantly more than men.?The elderly patients with anti-Sm antibody and anti-SSA antibody positive rate is lower than non-elderly group.Therefore,the elderly patients who were expected to diagnosed as SLE can not be excluded because of the negative antibodies.?WBC,HGB,PLT,ESR,C3,C4,uric acid and 24h urinary protein were improved after effective treatment,and can be used as indicators for illness evaluation and therapeutic effect.(4)Glucocorticoid was still the based treatment for SLE patients,supplemented by immunosuppressants and antimalarials. |
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