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SLE-DAS 在评估系统性红斑狼疮患者疾病活动度中的价值:一项单中心回顾性研究。

Value of SLE-DAS in assessing disease activity in patients with systemic lupus erythematosus: a single-centre retrospective study.

机构信息

Department of Rheumatology and Immunology, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

Department of Rheumatology and Immunology, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China

出版信息

Lupus Sci Med. 2024 Jun 10;11(1):e001196. doi: 10.1136/lupus-2024-001196.

Abstract

OBJECTIVES

This study aimed to evaluate the clinical value of the Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) for assessing disease activity in patients with SLE.

METHODS

Clinical data were collected from patients with SLE who were admitted at the Second Affiliated Hospital of Soochow University from January 2009 to December 2022. The glucocorticoid dose grading was used as the gold standard for disease activity assessment in SLE. The SLE-DAS value was calculated, and the SLE disease activity status was graded based on the SLE-DAS value. Another scoring criterion, the SLE Disease Activity Index 2000 (SLEDAI 2000), served as a control. Spearman correlation analysis was used to calculate the correlation between the scoring criteria and other variables.

RESULTS

The analysis included 396 patients with SLE. A strong correlation was found between SLE-DAS and SLEDAI 2000 (ρ=0.709, 95% CI 0.648 to 0.766, p<0.001), with median SLE-DAS and SLEDAI 2000 scores of 15.32 (7.90 to 24.45) and 13 (8 to 19), respectively. Compared with the SLEDAI 2000 value, the SLE-DAS value correlated better with glucocorticoid dose grading (ρ=0.434 vs 0.518), gammaglobulin use (ρ=0.170 vs 0.318) and immunosuppressant use (ρ=0.122 vs 0.221). A moderate correlation based on disease activity grading was found between SLE-DAS and glucocorticoid dose grading (ρ=0.441), whereas a mild correlation was observed between SLEDAI 2000 and glucocorticoid dose grading (ρ=0.325). Additionally, SLE-DAS revealed a positive correlation with severe thrombocytopenia, cardiac involvement and pulmonary involvement but not SLEDAI 2000.

CONCLUSION

Compared with SLEDAI 2000, SLE-DAS may provide a more accurate disease activity assessment in patients with SLE, especially those with severe thrombocytopenia and cardiopulmonary involvement.

摘要

目的

本研究旨在评估系统性红斑狼疮疾病活动度评分(SLE-DAS)用于评估系统性红斑狼疮患者疾病活动度的临床价值。

方法

收集 2009 年 1 月至 2022 年 12 月苏州大学附属第二医院收治的系统性红斑狼疮患者的临床资料。以糖皮质激素剂量分级为评估 SLE 疾病活动度的金标准。计算 SLE-DAS 值,并根据 SLE-DAS 值对 SLE 疾病活动度进行分级。另一个评分标准,SLE 疾病活动指数 2000(SLEDAI 2000)作为对照。采用 Spearman 相关分析计算评分标准与其他变量的相关性。

结果

本研究共纳入 396 例系统性红斑狼疮患者。SLE-DAS 与 SLEDAI 2000 呈强相关(ρ=0.709,95%CI 0.648 至 0.766,p<0.001),SLE-DAS 和 SLEDAI 2000 的中位数分别为 15.32(7.90 至 24.45)和 13(8 至 19)。与 SLEDAI 2000 值相比,SLE-DAS 值与糖皮质激素剂量分级(ρ=0.434 与 0.518)、γ球蛋白使用(ρ=0.170 与 0.318)和免疫抑制剂使用(ρ=0.122 与 0.221)相关性更好。SLE-DAS 与糖皮质激素剂量分级呈中度相关(ρ=0.441),而 SLEDAI 2000 与糖皮质激素剂量分级呈轻度相关(ρ=0.325)。此外,SLE-DAS 与严重血小板减少、心脏受累和肺部受累呈正相关,但与 SLEDAI 2000 无关。

结论

与 SLEDAI 2000 相比,SLE-DAS 可能为评估系统性红斑狼疮患者的疾病活动度提供更准确的信息,特别是在伴有严重血小板减少和心肺受累的患者中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f7d3/11168181/2448bb57247b/lupus-2024-001196f01.jpg

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