Analysis Of Clinical Features And Related Envirmomental Factors Of 109 Patients With Systemic Sclerosis

Objective To discuss the clinical characteristics of systemic sclerosis through retrospective analysis, and provide references for the diagnosis and treatment of the disease.Methods From August 2012 to November 2014, 109 SSc patients were recruited from Anhui Provincial Hospital and the First Affiliated Hospital of Anhui Medical University. Relevant information and medical record data were face-to-face interviewed by self-designed questionnaires. General information, clinical characteristics and laboratory data were analyzed.Results Among 109 patients with systemic sclerosis, males: females=1:9, the mean age was 48.50±11.90, the mean course of the disease was 5.19±5.63 years. The disease was occurred frequently among middle-aged females and manual workers. The mainly symptom of SSc was Raynaud phenomenon(RP, 66 patients), as the disease progresses further, many systems including gastrointestinal tract, joint and respiratory system will be implicated. There were 24 SSc patients accompanied by other diseases such as high blood pressure, coronary heart disease and interstitial pneumonia; there were also 16 SSc patients accompanied by upper respiratory tract, lungs, urinary tract and digestive tract infections. The highest positive rate was antinuclear antibody(ACA, 80.8%), and the others were antibody against antitopoisomerase I(Scl-70), Sjgren syndrome A(SSA), ribonucleoprotein(RNP) and anti-centromere antibody(ACA).Conclusion(1)The disease was occurred frequently among middle-aged females and manual workers;(2)The mainly symptom of SSc was RP, doctors should pay more attention to this, and get early detection, early diagnosis and early treatment;(3)Gastrointestinal tract, joint and respiratory system were the most affected systems, furthermore, few patients had multisystem involvement at the same time, doctors should pay more attention to the protective and preventative treatments of it;(4)Infection may affect the development of SSc, it is an important part to provide protective and preventative treatments for infection;(5)The detection of ANA, ACA and antibody against Scl-70 may be beneficial to the diagnosis of SSc.Objective To explore the impact of environmental related factors on systemic sclerosis(SSc) and provide references for etiology, pathogenesis, diagnosis, prevention and treatment of SSc.Methods 109 SSc patients from Anhui Provincial Hospital and the First Affiliated Hospital of Anhui Medical University and 436 female controls from communities of Hefei city were face-to-face interviewed by self-designed questionnaires. Univariate and multiple logistic regression analyses were used to examine the associations of environmental factors with SSc risk. In addition, we will combine the results of associations between female fertility factors and SSc in our study with related articles from home and abroad, and the consolidated result will be analyzed by meta-analysis.Results(1) Univariate analysis revealed that farmers, teachers/accountant/clerk, cobbler/textile worker/garment worker, body mass index, taking birth control pills, abortion, other contact people smoking, drinking, noise exposure, organic solvents exposure and history of drug allergy were associated with SSc.(2) After taking these factors into multiple logistic aggression analysis, farmers(OR = 5.396, 95%CI 2.833-10.276), teachers/accountant/clerk(OR = 10.823, 95%CI 3.445-34.003), cobbler/textile worker/garment worker(OR=17.235,95%CI 5.101-58.236), thinner(OR=3.359,95%CI 1.261-8.948), obesity(OR=0.486,95%CI 0.238-0.996), taking birth control pills(OR=3.886,95%CI 1.242-12.162), abortion(OR=5.232,95%CI2.593-10.557), other contact people smoking(OR=4.962,95%CI 2.945-9.866), noise exposure(OR=2.661,95%CI 1.235-5.731), organic solvents exposure(OR=4.948,95%CI 1.238-19.773) and history of drug allergy(OR=4.257,95%CI 1.739-10.419) were also related to the risk of SSc expect drinking.(3) The three articles which discussed the associations between female fertility factors and SSc recruited 3 192 patients with SSc and 13 030 controls. The results failed to find any significant associations of no history of fertility, taking oral contraceptive and abortion with the risk of SSc.Conclusion Many environmental factors were related to SSc. Preventive measures for SSc and rehabilitation measures for patients should be reinforced.