Characteristics And Risk Factors Of Osteonecrosis In Patients With Systemic Lupus Erythematosus

Objective: Through the study of clinical characteristics,auxiliary examinations and treatment regimens of Systemic Lupus Erythematosus(SLE)complicated with osteonecrosis,the risk factors of SLE complicated with osteonecrosis were discussed,which would provide clinical reference for early prevention,diagnosis and treatment.Methods: Collected from February 2012 to February 2018 in the Department of Rheumatology,first affiliated hospital of Bengbu Medical College lead of the initial diagnosis of patients with SLE,to follow-up of these patients,in the follow-up process ON 50 cases as observation group,at the same time in the hospital medical records complete not occurred ON 190 patients as control group.SPSS22.0 software was used for statistical analysis,the two groups of patients during the initial diagnosis of the clinical features,laboratory indexes and follow-up treatment on the single factor analysis of the eight factors will be statistically significant in whether osteonecrosis as dependent variable,these factors as independent variable multiariable Logistic regression analysis,further establish the risk factors associated with osteonecrosis.Results: 1.Among 50 patients with SLE complicated with osteonecrosis,there were 4males and 46 females.The duration of the disease was 1-240 months(mean 51.8months).The age of onset of the disease was 36.4±12.9 years,and the duration of the disease was 51.8±57.5 months.The age of onset in the group without osteonecrosis in SLE was(28.4±11.3)years.2.In patients with single factor analysis of the onset of age(P = 0.000),and clinical joint pain(P = 0.000),elevated c-reactive protein(P = 0.002),erythrocyte pressure product decrease(P = 0.044),high levels of IgG antibody(P =0.017),hormone shock therapy(P = 0.000),and hormone starting dose of 50 mg/d or higher(P = 0.042)and the average daily dose of hormone treatment 1 months or greater50 mg(P = 0.008)between the two groups was statistically significant difference(P <0.05).However,the patient’s gender,presence of fever,facial erythema,light allergy,dry mouth,dry eye,mouth ulcers,hair loss,fatigue,Renault phenomenon,limb skin rash,pericarditis,myocardial damage,pleural effusion,and whether application ofcyclophosphamide on white blood cells,reduce,red blood cells,thrombocytopenia,anemia,albumin drop,higher CHO,and TG,elevated uric acid,urine protein,urine occult blood,blood sedimentation increase fast,red blood cell volume,lymphocyte count,AST,ALT,ALP,GGT,ALB,uric acid,low density lipoprotein,ds-DNA resistance,anti-Sm,anti-SSA,anti-SSB,anti-U1 RNP,anti-Scl70 antibody and C3,C4,immunoglobulin A(IgA),immunoglobulin M(IgM)showed no significant difference between the case group and the control group(P>0.05).3.Multiple factors regression analysis found in SLE merger ON group with SLE without ON the onset age,joint pain,high levels of immunoglobulin G(IgG),impact line of large dose of hormone therapy and hormone therapy 1 months,an average dose of 50 mg or more comparative difference was statistically significant(P < 0.05),indicating that these factors associated with systemic lupus erythematosus complicated with osteonecrosis.Conclusion:1.Young onset age and high level of immunoglobulin G are risk factors for ON in SLE patients;2.Average daily dose of steroids greater than 50 mg/d in the first month of SLE initial treatment is a risk factor for ON in SLE patients;3.High-dose corticosteroid shock therapy during the course of disease is a risk factor for ON in SLE patients.