Guo Ruru, Zhou Yanqing, Lu Liangjing, Cao Lanfang, Cao Junjia
Department of Rheumatology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, P. R. China.
Department of Pediatrics, Central hospital of Jiading, Shanghai, P.R.China.
PLoS One. 2017 May 17;12(5):e0177774. doi: 10.1371/journal.pone.0177774. eCollection 2017.
The influence of co-existing atopy on the prognosis of juvenile systemic lupus erythematosus (JSLE) was assessed in this study. Patients diagnosed with JSLE between October 2005 and April 2016 were enrolled in a prospective study and followed up for 2 years. Management of patients was evaluated using the systemic lupus erythematosus disease activity index 2000 (SLEDAI-2K) score and laboratory variables. Eighty JSLE patients were enrolled at diagnosis and divided into those with (n = 35) and without (n = 45) atopy. When compared with the non-atopic group, atopic patients showed higher SLEDAI-2K score at disease onset (16.09 vs. 11.18), higher erythrocyte sedimentation rate (52.89 vs. 38.27 mm/h), higher percentage of total B-cells (25.85 vs. 19.51%), lower percentage (7.26 vs. 9.03%) and cytotoxicity (9.92 vs. 11.32%) of natural killer cells, and lower complement C3 (0.51 vs. 0.69 g/L) (all p<0.05). At 1, 3, 6, 12, 18, and 24 months, JSLE patients with atopy reached higher SLEDAI-2K score and lower ΔSLEDAI-2K improvement rate (at 1 month, 8.34 vs. 4.71 and 43.63 vs. 57.95%, respectively; at 3 months, 8.57 vs. 2.62 and 48.39 vs. 75.10%, respectively; at 6 months, 6.91 vs. 2.38 and 53.59 vs. 77.26%, respectively; at 12 months, 4.71 vs. 1.80 and 69.54 vs. 84.10%, respectively; at 18 months, 4.66 vs. 2.02 and 68.14 vs. 82.93%, respectively; at 24 months, 8.57 vs. 2.62 and 70.00 vs. 81.88%, respectively; all p<0.05). During the 24 months of follow-up, the total number of disease flares was higher in JSLE patients with co-existing atopy (3.77 vs. 1.51, p<0.05), and the atopic group needed much more time to reach the stable condition of the disease (6.88 vs. 4.65 months, p<0.05). JSLE patients combined with co-existing atopy had more severe disease at diagnosis and poorer outcomes than JSLE patients without atopy.
本研究评估了共存特应性对青少年系统性红斑狼疮（JSLE）预后的影响。2005年10月至2016年4月期间诊断为JSLE的患者纳入一项前瞻性研究，并随访2年。使用系统性红斑狼疮疾病活动指数2000（SLEDAI - 2K）评分和实验室指标评估患者的病情管理情况。80例JSLE患者在诊断时入组，分为有特应性（n = 35）和无特应性（n = 45）两组。与非特应性组相比，特应性患者在疾病发作时SLEDAI - 2K评分更高（16.09对11.18），红细胞沉降率更高（52.89对38.27 mm/h），总B细胞百分比更高（25.85对19.51%），自然杀伤细胞百分比更低（7.26对9.03%）和细胞毒性更低（9.92对11.32%），补体C3更低（0.51对0.69 g/L）（均p<0.05）。在1、3、6、12、18和24个月时，有特应性的JSLE患者SLEDAI - 2K评分更高，ΔSLEDAI - 2K改善率更低（1个月时，分别为8.34对4.71和43.63对57.95%；3个月时，分别为8.57对2.62和48.39对75.10%；6个月时，分别为6.91对2.38和53.59对77.26%；12个月时，分别为4.71对1.80和69.54对84.10%；18个月时，分别为4.66对2.02和68.14对82.93%；24个月时，分别为8.57对2.62和70.00对81.88%；均p<0.05）。在24个月的随访期间内，共存特应性的JSLE患者疾病发作总数更多（3.77对1.51，p<0.05），且特应性组达到疾病稳定状态所需时间更长（6.88对4.65个月，p<0.05）。与无特应性的JSLE患者相比，共存特应性的JSLE患者在诊断时病情更严重，预后更差。
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