The Meta-Analysis Of Risk Factors Of Neuropsychiatric Systemic Lupus Erythematosus

Objective:This article analyzes systematically the risk factors of neuropsychiatric systemic lupus erythematosus with the way of a meta-analysis,and provides evidence-based evidence for clinical practice,which could provide better prevention and diagnosis for the disease.Methods:Relevant literatures of risk factors of neuropsychiatric systemic lupus erythematosus were searched from the English databases(PubMed,EMBASE,the Cochrane Library)and the Chinese databases(CNKI,Wanfang Database,Full-text Database of Chinese Sci-tech Journals).The time of searching is set from 2000 to 2018.According to the inclusion and exclusion criteria,the high-quality literatures that met the inclusion criteria were screened and the datas were extracted after browsing the topic,abstract and full text.The meta-analysis of the results was performed by Revman 5.3.Results:A total of 20 articles were included in this study,the total sample size was 4067 cases,there were 1314 cases of lupus encephalopathy and 2753 cases of lupus non-encephalopathy.The result of this meta-analysis showed that: ? A total of 11 articles discussed the relationship between leukocytopenia and lupus encephalopathy,and the results were statistically significant [OR = 1.30,95% CI(1.08,1.57),P = 0.006];?A total of 13 articles discussed the relationship between thrombocytopenia and lupus encephalopathy,and the results were statistically significant [OR = 1.84,95% CI(1.51,2.25),P < 0.00001];? A total of 6 articles discussed the relationship between ESR and lupus encephalopathy,and the results were statistically significant [OR = 2.45,95% CI(1.76,3.40),P < 0.00001];?A total of 12 articles discussed the relationship between C3 level and lupus encephalopathy,and the results were statistically significant [OR = 2.10,95% CI(1.66,2.65),P < 0.00001];? A total of 12 articles discussed the relationship between C4 level and lupus encephalopathy,and the results were statistically significant [OR = 2.70,95% CI(2.14,3.39),P < 0.00001];?A total of 9 articles discussed the relationship between antiphospholipid antibody and lupus encephalopathy,and the results were statistically significant [OR = 2.05,95% CI(1.72,2.46),P < 0.00001];?A total of 12 articles discussed the relationship between anti-SSA antibody and lupus encephalopathy,and the results were statistically significant [OR = 0.80,95% CI(0.67,0.96),P = 0.02];? A total of 7 articles discussed the relationship between discoid erythema and lupus encephalopathy,and the results were statistically significant [OR = 0.45,95% CI(0.30,0.67),P <0.0001];? A total of 7 articles discussed the relationship between RBC reduction and lupus encephalopathy,and the results were not statistically significant[OR = 1.58,95% CI(0.95,2.64),P = 0.08];? A total of 16 articles discussed the relationship between anti-ds-DNA antibody and lupus encephalopathy,and the results were not statistically significant [OR = 0.94,95% CI(0.72,1.25),P = 0.69];? A total of 11 articles discussed the relationship between anti-SSB antibody and lupus encephalopathy,and the results were not statistically significant [OR = 0.84,95% CI(0.65,1.07),P = 0.16];? A total of 13 articles discussed the relationship between anti-Sm antibodies and lupus encephalopathy,and the results were not statistically significant [OR = 1.14,95% CI(0.92,1.42),P = 0.21];? A total of 14 articles discussed the relationship between anti-ANA antibody and lupus encephalopathy,and the results were not statistically significant [OR = 1.14,95% CI(0.81,1.61),P = 0.46];? A total of 10 articles discussed the relationship between butterfly erythema and lupus encephalopathy,and the results were not statistically significant [OR =1.08,95% CI(0.91,1.27),P = 0.39].Conclusion:(1)leukocytopenia,thrombocytopenia,ESR increased,abnormally decreased C3 and C4level,antiphospholipid antibody positive are important risk factors of lupus encephalopathy.(2)discoid erythema,anti-SSA antibody positive are protective factors of lupus encephalopathy.(3)red blood cells,butterfly erythema,anti-ds-DNA antibody,anti-SSB antibody,anti-Sm antibody,anti-ANA antibody are not related to the occurrence of lupus encephalopathy.