Zhou Jie-Qing, Jiang Hong
Department of Pediatrics, First Hospital of China Medical University, Shenyang 110001, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2012 Oct;14(10):775-9.
To study feasibility of Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2000) and British Isles Lupus Assessment Group 2004 (BILAG-2004) scoring systems for assessing renal disease activity in children with lupus nephritis (LN).
The clinical data of 159 children with systemic lupus erythematosus (SLE) and LN were collected, and disease activity was assessed by SLEDAI-2000 and BILAG-2004 scoring systems. The correlations between SLEDAI-2000 and BILAG-2004 scores and 24-hour urinary protein excretion and renal pathology index were analyzed. The SLEDAI-2000 and BILAG-2004 scoring systems were evaluated using ROC curve.
Approximately one third (31.5%) of the 159 children had a moderate level of 24-hour urinary protein excretion. Among the 37 patients undergoing renal biopsy, 46.0% had diffuse LN (type Ⅳ). 24-hour urinary protein excretion was positively correlated with both SLEDAI-2000 (r=0.36, P<0.05) and BILAG-2004 scores (r= 0.39, P<0.05). Children with types Ⅰ, Ⅱ, Ⅲ, and Ⅳ LN had pathology activity index (AI) which positively correlated with SLEDAI-2000 scores (r=0.86, 0.88, 0.84, 0.77 respectively; P<0.05) and BILAG-2004 scores (r= 0.88, 0.98, 0.86, 0.89 respectively; P<0.05). SLEDAI-2000 score showed the best correlation with AI in patients with type Ⅱ LN, followed by those with type Ⅰ LN. BIILAG-2004 score showed the best correlation with AI in patients with type Ⅱ LN, followed by those with type Ⅳ LN. The BILAG-2004 scoring system had an area under the ROC curve (AUC) of 0.93, and the SLEDAI-2000 scoring system had an AUC of 0.88.
BILAG-2004 and SLEDAI-2000 scoring systems can be used to assess renal disease activity of patients with LN. The BILAG-2004 scoring system can provide more reliable and comprehensive assessment.
研究系统性红斑狼疮疾病活动指数2000（SLEDAI - 2000）和不列颠群岛狼疮评估组2004（BILAG - 2004）评分系统评估狼疮性肾炎（LN）患儿肾脏疾病活动度的可行性。
收集159例系统性红斑狼疮（SLE）合并LN患儿的临床资料，采用SLEDAI - 2000和BILAG - 2004评分系统评估疾病活动度。分析SLEDAI - 2000和BILAG - 2004评分与24小时尿蛋白排泄量及肾脏病理指标之间的相关性。采用ROC曲线对SLEDAI - 2000和BILAG - 2004评分系统进行评价。
159例患儿中约三分之一（31.5%）24小时尿蛋白排泄量处于中度水平。在37例行肾活检的患者中，46.0%为弥漫性LN（Ⅳ型）。24小时尿蛋白排泄量与SLEDAI - 2000（r = 0.36，P < 0.05）和BILAG - 2004评分（r = 0.39，P < 0.05）均呈正相关。Ⅰ、Ⅱ、Ⅲ和Ⅳ型LN患儿的病理活动指数（AI）与SLEDAI - 2000评分（分别为r = 0.86、0.88、0.84、0.77；P < 0.05）和BILAG - 2004评分（分别为r = 0.88、0.98、0.86、0.89；P < 0.05）均呈正相关。SLEDAI - 2000评分在Ⅱ型LN患者中与AI的相关性最佳，其次是Ⅰ型LN患者。BIILAG - 2004评分在Ⅱ型LN患者中与AI的相关性最佳，其次是Ⅳ型LN患者。BILAG - 2004评分系统的ROC曲线下面积（AUC）为0.93，SLEDAI - 2000评分系统的AUC为0.88。
BILAG - 2004和SLEDAI - 2000评分系统可用于评估LN患者的肾脏疾病活动度。BILAG - 2004评分系统能提供更可靠、更全面的评估。
