| Objectives:In order to increse the knowing of systemic sclerosis(SSc),a rare autoimmune disease,we analysed the clinical and serological features of SSc patients hospitalized in the second affiliated hospital of Kunming Medical University in recent 5 years.Evaluating the risk factors for ILD and haematological involvement in SSc.Then finding some early interventions to improve prognosis.Moreover,accumulating more clinical experience for the treatment and management of SSc.Methods:This retrospective study included 163 patients who were diagnosed with SSc according to the related criteria from January 2015 to December 2020 in the the second affiliated hospital of Kunming Medical University.The demographic datas,clinical characteristics and laboratory results were reviewed.Data analyses were performed using SPSS26.0 statistical software.The data were presented as mean±SD or median(P25,P75).Correspondingly,comparison of continuous variables between two groups using Student’s t-test or Mann-Whitney U test.The chi-squared and Fisher exact tests were used to define associations among dichotomized variables.Logistic regression analysis was used to evaluate the risk factors for ILD and haematological involvement in SSc.For correlation analysis,we used Spearman correlation test.A P-value<0.05 indicated statistical significance.All pictures were drawn using GraphPad Prism 8.0.Results:1.Of the 163 patients with SSc,56 were male and 107 were female,with a ratio of 1:1.91.There were 49 lcSSc(30.1%)patients and 95 dcSSc(58.3%)patients,with a ratio of 1:1.94.Furthermore,14 cases of overlap syndrome(8.6%),4 cases of UCTD(2.5%)and 1 case of sine scleroderma(0.6%).No differences existed in nationalities,regions,ILD and haematological involvement about disease subtypes(P>0.05).The age of onset was(44.95±15.07)years old,and mean disease duration was 1.5(0.5-4.0)years.2.DcSSc was more common in male.Male has higher mRSS score than female,as well as shorter disease duration,lower frequencies of Raynaud phenomenonshorter,ACA and anti-RNP/SM antibodies(P<0.05).However,no differences existed in the other clinical and laboratory features between male and female.3.92(56.4%)patients were from rural areas and 71(43.6%)patients were from urban areas.Farmers were the main occupations with a number of 76(47.0%).No significant difference was observed in disease characteristics between rural and urban patients(P>0.05).4.There were 111 Han people(68.1%)and 52 ethnic minorities(31.9%).The former had lower mRSS score,frequencies of joint involvement,Scl-70 antibody and level of fibrinogen than the later(P<0.05).Other differences were not observed.5.The onset age of SSc-ILD patients was older.The frequencies of cardiac involvement,anti-β2 glycoprotein antibody were higher in SSc-ILD,as well as the levels of RDW,ESR,fibrinogen and ferritin,but lower frequency of ACA(P<0.05).Variables with P-value<0.1 were included in multivariate logistic regression analysis.Finding that anti-β2 glycoprotein antibody,ferritin and ESR were independent risk factors for ILD.The AUC were 0.677,0.704 respectively(CI 95%0.589-0.766,0.624-0.785 respectively).The cutoff of ferritin was 224.095ng/ml with 72.7%sensitivity and 60.2%specificity.The cutoff of ESR was 16.965mm/1h with 80.0%sensitivity and 53.7%specificity.6.The haematological involvement patients had higher frequencies of acial,renal involvemen,Coombs and anti-RNP/SM antibody,as well as higher levels of globulin,IgG,IgA,ESR,CRPS IL-6 and ferritin,but lower levels of albumin,complement C3 and complement C4(P<0.05).Variables with P-value<0.1 were included in multivariate logistic regression analysis.Showing that globulin was an independent risk factor for haematological involvement.The AUC was 0.672(CI 95%0.569-0.775).The cutoff was 32.05g/L with 61.0%sensitivity and 73.0%specificity.7.The results of Spearman correlation analysis showed that MLR,NLR,PLR and RDW were positively correlated with ESR and ferritin(P<0.05),but not with CRP(P>0.05).IL-6 was positively correlated with ESR,ferritin and CRP(P<0.001).8.There were 13 patients receiving traditional therapy(glucocorticoid+immunosuppressant)combined with TCZ 8mg/kg/month.10 patients insisted on getting treatment more than 3 months,and 9 of them more than 6 months.After 3 months of treatment,the mRSS score was not different from the baseline(P>0.05),but the mRSS score and level of ESR were lower than the baseline after 6 months of treatment(P<0.05).However,no differences existed in patients choosing traditional treatment after 3 and 6 months of treatment(P>0.05).Conclusions:1.DcSSc was the main subtype of SSc in this study.2.Multivariate logistic regression analysis showed that anti-β2 glycoprotein antibody,ferritin and ESR were independent risk factors for the occurrence of ILD.3.This study found that globulin was an independent risk factor for haematological involvement in SSc.4.This study found that MLR,NLR,PLR and RDW were positively correlated with ESR and ferritin. |
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