Driest K D, Sturm M S, O'Brien S H, Spencer C H, Stanek J R, Ardoin S P
Department of Pediatrics, Nationwide Children's Hospital, OH, USA
Department of Pediatrics, Nationwide Children's Hospital, OH, USA.
Lupus. 2016 Jun;25(7):749-53. doi: 10.1177/0961203316638164. Epub 2016 Mar 14.
The risk of thrombosis is increased in patients with systemic lupus erythematosus (SLE). Few studies have assessed factors associated with thrombosis within the pediatric SLE (pSLE) population. We sought to better characterize these associated factors in pSLE patients using the Childhood Arthritis & Rheumatology Research Alliance (CARRA) registry.
Within the CARRA registry, patients with a history of thrombosis were compared to those without. Univariate logistic regression was used to calculate odds ratios. A multivariable logistic regression model was conducted that included variables from the univariate analysis that had a p value < 0.10 and other variables identified as clinically significant from published literature.
Among the 979 pSLE patients in the CARRA registry, 24 (2.5%) patients had a history of arterial thrombosis and 35 (3.6%) of venous thrombosis. In the univariate analysis, the odds ratio of having a thrombotic event were found to be significantly higher in patients with a history of vasculitis, avascular necrosis (AVN), or antiphospholipid antibody (aPL). Similar results were found for vasculitis, AVN, and aPL in the multivariable analysis.
Our study of pSLE patients suggests that vasculitis, positive APL, and AVN are associated with thrombotic events in this population.
系统性红斑狼疮（SLE）患者发生血栓形成的风险增加。很少有研究评估儿童SLE（pSLE）人群中与血栓形成相关的因素。我们试图利用儿童关节炎与风湿病研究联盟（CARRA）登记系统更好地描述pSLE患者中的这些相关因素。
在CARRA登记系统中，将有血栓形成病史的患者与无血栓形成病史的患者进行比较。采用单因素逻辑回归计算比值比。进行多因素逻辑回归模型分析，纳入单因素分析中P值<0.10的变量以及从已发表文献中确定的具有临床意义的其他变量。
在CARRA登记系统的979例pSLE患者中，24例（2.5%）有动脉血栓形成病史，35例（3.6%）有静脉血栓形成病史。在单因素分析中，有血管炎、无血管性坏死（AVN）或抗磷脂抗体（aPL）病史的患者发生血栓形成事件的比值比显著更高。在多因素分析中，血管炎、AVN和aPL也得到了类似结果。
我们对pSLE患者的研究表明，血管炎、APL阳性和AVN与该人群的血栓形成事件相关。
