血小板减少症作为系统性红斑狼疮的预后标志物：系统评价和荟萃分析。
Thrombocytopenia as a Prognostic Marker for Systemic Lupus Erythematosus: A Systematic Review and Meta-analysis.
机构信息
Department of Rheumatology and Immunology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China; Department of Rheumatism, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China.
Department of Rheumatology and Immunology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
出版信息
Am J Med Sci. 2019 Jun;357(6):461-467. doi: 10.1016/j.amjms.2019.03.002. Epub 2019 Mar 11.
BACKGROUND
Systemic lupus erythematosus (SLE) patients often exhibit hematological abnormalities, but the role of thrombocytopenia on the prognosis of SLE shows inconsistent results. The purpose of this meta-analysis was to confirm the impact of thrombocytopenia on mortality and end organ damage in patients with SLE.
MATERIALS AND METHODS
Three electronic databases, PubMed, Embase and Cochrane library were systematically searched to identify the eligible studies from inception to November 2017 in order to evaluate the impact of thrombocytopenia on the prognosis of patients with SLE. The summary odds ratios (ORs) and 95% confidence intervals (CIs) were used to measure the impact of thrombocytopenia on mortality and end organ damage based on the random-effects model.
RESULTS
A total of 8 studies that reported data on 2,158 patients with SLE were included. The summary OR indicated that SLE subjects with thrombocytopenia were significantly associated with an increased risk of mortality (OR: 4.57; 95% CI: 2.28-9.17; P < 0.001) and end-organ damage (OR: 3.31; 95% CI: 1.11-9.86; P = 0.031). Furthermore, the sensitivity analysis indicated stable mortality, while the result for end organ damage was variable. In addition, the patients with thrombocytopenia with disease duration <60 months presented a greater risk for mortality than those with disease duration ≥60.0 months (P = 0.002).
CONCLUSIONS
Patients with SLE and thrombocytopenia were found to be associated with an increased risk of mortality and end organ damage.
背景
系统性红斑狼疮（SLE）患者常出现血液学异常，但血小板减少症对 SLE 预后的影响结果并不一致。本荟萃分析的目的是确认血小板减少症对 SLE 患者死亡率和终末器官损害的影响。
材料和方法
系统检索了 PubMed、Embase 和 Cochrane 图书馆三个电子数据库，以确定从成立到 2017 年 11 月的合格研究，以评估血小板减少症对 SLE 患者预后的影响。采用随机效应模型，根据汇总优势比（OR）和 95%置信区间（CI）来衡量血小板减少症对死亡率和终末器官损害的影响。
结果
共有 8 项研究报道了 2158 例 SLE 患者的数据。汇总 OR 表明，血小板减少症的 SLE 患者死亡风险显著增加（OR：4.57；95%CI：2.28-9.17；P<0.001）和终末器官损害（OR：3.31；95%CI：1.11-9.86；P=0.031）。此外，敏感性分析表明死亡率是稳定的，而终末器官损害的结果是可变的。此外，血小板减少症患者的疾病持续时间<60 个月与疾病持续时间≥60.0 个月相比，死亡率更高（P=0.002）。
结论
SLE 合并血小板减少症患者的死亡率和终末器官损害风险增加。
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