中性粒细胞减少症与系统性红斑狼疮的早期严重感染有关。

Adjusted neutropenia is associated with early serious infection in systemic lupus erythematosus.

机构信息

Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea.

出版信息

Mod Rheumatol. 2013 May;23(3):509-15. doi: 10.1007/s10165-012-0666-1. Epub 2012 Jun 8.

DOI:10.1007/s10165-012-0666-1

PMID:22678568

Abstract

OBJECTIVES

The susceptibility to infection increases in systemic lupus erythematosus (SLE) patients with neutropenia, but the link between infection risk and the cutoff neutrophil count still remains controversial. In this study, we investigated a valuable parameter associated with early serious infection in SLE patients during the first follow-up year.

METHODS

We reviewed the medical records of 160 patients with SLE. The initial levels were defined as the mean of the results of the first two consecutive tests. The adjusted levels were defined as the results of the accumulated area under the curve divided by interval follow-up days. Patients were divided into two groups according to early serious infection and initial and adjusted neutropenia and were then compared.

RESULTS

Immunosuppressive-naïve SLE patients with early serious infection more frequently had initial, latest, and adjusted leukopenia and neutropenia (<2,500/mm(3)) and hypocomplementemia than those without. Adjusted neutropenia was the only independent predictive value for early serious infection [odds ratio (OR 11.366)]. Initial neutropenia was the independent predictive value for adjusted neutropenia (OR 6.504).

CONCLUSIONS

We suggest that adjusted neutropenia is useful for predicting early serious infection in SLE patients during the first follow-up year.

摘要

目的

中性粒细胞减少症会增加系统性红斑狼疮（SLE）患者的感染易感性，但感染风险与中性粒细胞计数临界值之间的联系仍存在争议。本研究旨在探讨 SLE 患者在首次随访年内发生早期严重感染的相关有价值的参数。

方法

我们回顾了 160 例 SLE 患者的病历。初始水平定义为前两次连续检测结果的平均值。调整水平定义为累积曲线下面积除以间隔随访天数的结果。根据早期严重感染和初始及调整中性粒细胞减少症将患者分为两组，然后进行比较。

结果

与无早期严重感染的患者相比，免疫抑制初治 SLE 患者的早期严重感染更常伴有初始、最新和调整后的白细胞减少和中性粒细胞减少症（<2500/mm³）和低补体血症。调整后的中性粒细胞减少症是早期严重感染的唯一独立预测值[比值比（OR）11.366]。初始中性粒细胞减少症是调整后中性粒细胞减少症的独立预测值（OR 6.504）。