Analysis Risk Factors Of Venous Thromboembolism In Patients With Systemic Lupus Erythematosus

ObjectiveThe aim of our research was to find the clinical characteristics and risk factors of venous thromboembolism(VTE)in patients with systemic lupus erythematosus,so we can screen out high risky patients and intervene early,in order to reduce the occurrence of a fatal pulmonary embolism event,and improve the quality of life.MethodsA retrospective study was taken to collect the clinical date of 1956 patients with systemic lupus erythematosus,which hospitalized in the Affiliated Union Hospital of Huazhong University of Science and Technology,from January 1,2012 to September 30,2019.There are 39 lupus patients with VTE,then we randomly selected 78 SLE patients without VTE as the control group.Clinical date about the two groups were collected,including demographic information,Systemic Lupus Erythematosus Disease Activity Index,organ involvement,laboratory dates,medication record and other traditional risk factors for VTE,such as hypertension,diabetes,hyperlipemia and so on.Finally,the independent risk factors were obtained by univariable and multiple logistic regression analyses.We analyzed the relationship between Systemic Lupus Erythematosus Disease Activity Index 2000(SLEDAI 2K)and cytokines,inflammatory indicators,complement with rank correlation analysis,the same method was used to analyze the link between anticardiolipin antibody and cytokines,inflammatory indicators,complement.Result1.The incidence of VTE in systemic lupus erythematosus in our hospital was about 1.99%,the average age of 39 patients was 42.97±13.65 years,including 4 males and 35 females,and the median disease course of SLE was 2(0,60)months.In the SLE patients with VTE,there were 20 patients with deep venous thrombosis,5 patients with pulmonary embolism,14 patients with pulmonary embolism and deep venous thrombosis.Among they,the overall mortality was not high,only one patient died of acute massive pulmonary embolism.Deep venous thrombosis of the lower extremity was more common in the intermuscular vein.2.Univariable analyses showed a statistical difference in age,albumin,SLEDAI 2K,leucocyte count,hemoglobin,IL-2,TNF-α,CRP,ESR,active lupus nephritis,hyperlipidemia,and antiphospholipid antibody syndrome,P <0.05.3.Multivariable logistic analyses showed that lower albumin(P =0.038),higher IL-6(P =0.013),antiphospholipid antibody syndrome(P =0.042)and higher CRP(P =0.017)were independent risk factors for SLE patients with VTE.4.The rank correlation analysis found that IL-6 level was higher in the mediumhigh disease activity group(SLEDAI 2K >4)than in the low disease group(SLEDAI 2K ≤4).5.The level of ESR was higher in anticardiolipin antibody-positive patients than the negative patients,and there was no statistical difference in cytokines and SLEDAI 2K.Conclusion1.The incidence of VTE in systemic lupus erythematosus in our hospital was about 1.99%,its mortality was not high,and active massive pulmonary embolism was the leading cause of death.Among deep venous thrombosis of the lower extremity,intermuscular vein was more common.2.Antiphospholipid antibody syndrome(APS),hypoproteinemia,higher IL-6 and CRP were all independent risk factors for SLE patients with VTE.3.There was a positive correlation between the increase in SLEDAI 2K and IL-6.4.Anticardiolipin antibody was not associated with cytokines and SLEDAI 2K.