| Objective Systemic Lupus Erythematosus(SLE)is a chronic autoimmune disease that can involve multiple organs or systems,with varied clinical symptoms due to different organs involved.As a chronic disease,SLE is difficult to cure,presenting the characteristics of alternating acute attack and remission in the natural course of disease.Patients often experience disease activities for many times,which not only damages the body of patients,but also adds a heavy mental and economic burden for patients and their families,affecting the work and life of patients.A correct understanding of the pattern of flare or clinical characteristics of SLE is helpful to judge the flare more quickly and accurately.And the flare of the disease is difficult to predict,any stage may have the activity of the disease,the cause of the flare of the disease can not be determined.Understanding the risk factors of SLE flare is of great significance for the prediction of disease flare and the evaluation of disease activity,which is of great significance for improving the prognosis and quality of life of patients.Objective of this study,through retrospective analysis of clinical and laboratory indicators at the onset and flare of the disease,to understand the course pattern in flare of SLE patients and the risk factors of flare,so as to further timely and accurate judgment of flare,timely treatment and preventio.Methods All SLE patients admitted to the Second Affiliated Hospital of Anhui Medical University from June 2009 to December 2022 were collected.Patients with complete clinical data required for regular follow-up were screened,and clinical characteristics,laboratory tests and treatment plans were recorded.A total of 230 SLE patients were collected,including 88 patients with flare.t test,Chi-square test,kappa test,Kaplan-Meier survival analysis,Log-Rank test and Cox regression analysis were used to explore the relationship between various factors and SLE flare.Results 1 There were 19 cases(21.59%)of patients with identical clinical manifestations at the time of flare,8 cases(9.09%)of patients with clinical manifestations at the time of flare included clinical manifestations at the time of initial onset but new symptoms,and 40 cases(45.46%)of patients with reduced clinical manifestations at the time of flare included clinical manifestations at the time of initial onset.There were 21 cases(23.86%)in which the clinical manifestations at flare were completely different from those at the initial onset.2.Fatigue,nephritis,leukopenia,hemolytic anemia,thrombocytopenia and other symptoms appear in the patient’s first onset and flare of the disease are consistent,these symptoms are more likely to flare.The proportion of flare patients with fever,rash,hair loss,Raynaud’s phenomenon,and arthritis decreased,but the proportion of patients with nephritis increased.3.Univariate analysis suggested that the course of disease between the two groups was less than 2 years,and the onset of fever,alopecia,rash,Raynaud’s phenomenon,arthralgia,nephritis,leukopenia,positive anti-ds DNA antibody,withdrawal of glucocorticoid and withdrawal of hydroxychloroquine were associated with SLE flare,which was statistically significant.4.Cox regression analysis indicated that rashes,nephritis and positive double-stranded DNA antibody were related to flare.Rash,nephritis and positive double-stranded DNA antibodies at onset are independent risk factors for flare of SLE.Conclusion Most flare of SLE occurs in the original organ or viscera,and a high proportion of flare cases involve new organs.Patients with kidney involvement and double-stranded DNA antibodies positive SLE and patients diagnosed SLE within 2 years should be closely monitored for disease activity and avoid discontinuation of glucocorticoid and HCQ in order to prevent flare. |
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