The Analysis Of Related Factors For Avascular Necrosis Of The Femoral Head In Systemic Lupus Erythematosus

Objective : To explore the related factors of avascular necrosis of the femoral head in systemic lupus erythematosus through a case-control study of retrospective.Methods: A case-control study of clinical features, laboratory and radiological data , and therapeutic measures of 80 SLE patients from a statistical point of view form Oct.1,2003 to Oct.1,2008, include 40 SLE patients with ANFH(case group) and 40 SLE patients without ANFH (control group).Two groups were matched for age, sex, living condition, ethnicity,etc.Results: 40 SLE patients (case group) had ANFH , giving a point prevalence of approximately 1%. Average age of the case group was 26.95±6.162 ( x士S) years. Its duration range of having developed ANFH was from 1 month to 126 months ( Median:26 months). There was statisticaly significant differences (p < 0.05) in the presence of these related factors which were raynaud phenomenon , vasculitis of the skin , dental ulcer , antiphospholipid antibody and MP pulse between case group and control group. And every case with ANFH had significantly greater for their mean oral glucocorticosteroid doses during the first month and the first 1～2,3～6,7～12 months of therapy as compared with control group(P <0.05), so did the two related factors which was their cumulative oral glucocorticosteroid doses during the first year and their pulses of methylprednisolone. In the mulivarine analysis of logistic regression , only the first 12-month cumulative oral glucocorticosteroid doses remained as a independent risk factor(OR=2.299, P<0.001, 95%CI=1.478～3.576), and age was a protective factor( OR=0.859, P=0.002, 95%CI=0.781～0.943) for ANFH.Conclusion: the SLE patients with ANFH were associated with age, raynaud phenomenon , vasculitis of the skin , dental ulcer , antiphospholipid antibody, MP pulse and therapeutic measures of cocorticosteroid during the first year through univariate analysis .Of related factors mentioned above, the later two related factors were closely associated with ANFH. However,only only the first 12-month cumulative oral glucocorticosteroid doses remained as an independent risk factor, and age was a protective factor for ANFH in the logistic regression .