Clinical Analysis Of 572 Cases Of In-patients With Systemic Lupus Erythematosus

Objective To summarize the characteristics of Epidemiology,clinical manifestation and regular laboratory examination and medication situation.And to assess the utility of measurement of laboratory parameters in the diagnosis,evaluating the disease activity and exploring the influence of hormonal therapy.Then to draw experiences and lessons from the summary of SLE,seek the clinical commonness and characteristics of SLE beneficial to the earlier diagnosis and therapy,raise curative effect, prolong the survival period and improve the life quality of the patients.Methods Retrospective epidemiological survey was used on 572 hospitalized SLE patients in the affiliated hospital of Bengbu Medical College from January 1997 to December 2007. Their general condition ,career, the first symptom,clinical manifestation, index of laboratory examination, family history ,prognosis and the degree of disease activity were collected and then made a related conclusion by statistical analysis.Results1. Demographic details: The study cohort comprised 540 female and 32 male patienis,the ratio of women to men was l:16.88.The number of city patients was 153,and the number of countryside patients was 419,the city and countryside proportion is 1:2.7.The average age was 33.55 years.The average age of the onset of the disease was 18.67,a mean follow-up of 20.37 months.The mean duration in hospital was 16.50 days.The number of the patients with active-stage was 463,the number of the patients with inactive-stage was 100.The number of the patients of first morbidity was 215 and the number of the patients of once more morbidity was 357.2. Clinical features: The onset maniefstation was arthritic ache,its frequence was 58.6%.The cumulative frequeneies of organic involvement were: urinary system 42.1% was in the first place,respiratory system 21.2%,haematological 19.8%,digesting system 7.3% and neurological 7.2%.3. Laboratory data:3.1 The frequence of hematological exceptionally was 19.76%. The PLT of different case groups showed significant difference in its incidence rate of decrease, its formation rate in the slightly active group was higher than the basically inactive group and medially active group(P<0.05). The WBC of different case groups showed no obvious difference in its incidence rate of decrease.3.2 The positive rates of the Urine protein and Urine occult blood(OB)in the urine RT respectively were 50.7%,26.2%.Abnormity rate of the 24 hours Urine protein(24hUPr) was 89.5%.3.2 The increase incidence rates of the ESR and CRP respectively were 73.1%,26.2%;it was showed obvious difference in the increase incidence rate of the ESR was shown in different groups (P<0.05),and the ESR level in different groups was significant different (P<0.05),too, its level increased with the degree of the disease activity.3.4 The positive rate of the anti-dsDNA and anti-Sm respectively were 56.0%, 56.4%,;The incidence rate of the C3 decrease and C4 decrease respectively were 36.6%, 18.7%. The C3 in its decrease incidence rate and anti-dsDNA in its positive rate in different groups were significantly different(P<0.05).4. Treatment: Hormone is the best curative thearpy strategis: The total number of the patients with hormone was 554,its percentage was 97.0%.Conclusion1. The male/female ratio in the hospital and patients age accords with disease disciplinarian.2. The main initial symptoms were arthrodynia and arthritis.They can be used as the significant clinical characteristics.3. The most important organ damage is kidney,Next came respiratory system and hematological system.4. There were no statistically significant difference in the correlation of the level of leucocyte and the activity degree of SLE.5. The incidence of the CRP increase, the incidence of the C4 decrease and the positive rate of the anti-Sm have no obvious correlation with the disease activity degree of SLE.6. It was showed obvious difference in the incidence of the ESR increase, the incidence of the C3 decrease and the positive rate of the anti-dsDNA was shown in different groups (P<0.05),and the ESR level in different groups was significant different (P<0.05),too.So the ESR level may be an index in the judgement of the disease activity in SLE.7. The main drugs for treatment still was hormone, its usage rate was 97.0%. Hormone should be used properly to prevent the infection of the patients.