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目的探讨影响神经精神狼疮(NPSLE)患者预后相关因素。方法对76例NPSLE患者进行回顾性分析并逐例随访至2005年12月底。先对患者的57项临床相关因素进行COX回归模型单因素分析,再将有意义的变量进行COX回归模型多因素分析,分析NPSLE预后相关因素。结果76例NPSLE患者中共有14种神经精伸症状,单因素分析显示病程、感染、横贯性脊髓炎、浆膜炎、糖尿病、中重度贫血、低蛋白血症、白球比例、蛋白尿、血小板减少、红细胞沉降率、环磷酰胺(CTX)的应用12项因素与NPSLE的预后相关(P<0.05)。进一步行多因素分析,结果显示感染、横贯性脊髓炎、中重度贫血、血小板减少与NPSLE不良预后相关(P<0.05),是独立的危险因素.而CTX的应用与NPSLE预后改善相关(P<0.05),是独立的保护性因素。结论感染、横贯性脊髓炎、血小饭减少、中重度贫血是NPSLE颅后的高危因素,提示预后不良;而CTX的应用是疾病预后的保护性因素,可提高NPSLE患者的生存率,应早期应用。
Objective To investigate the prognostic factors in patients with neuropathic lupus (NPSLE). Methods 76 patients with NPSLE were retrospectively analyzed and followed up by the end of December 2005. First of all 57 patients with clinical factors associated with COX regression model univariate analysis, and then meaningful variables COX regression model multivariate analysis, analysis of NPSLE prognostic factors. Results A total of 14 neurological spermatogenic symptoms were found in 76 patients with NPSLE. Univariate analysis showed that the course of disease, infection, transverse myelitis, serositis, diabetes mellitus, moderate to severe anemia, hypoproteinemia, white ball ratio, proteinuria, thrombocytopenia , Erythrocyte sedimentation rate and the application of CTX were related to the prognosis of NPSLE (P <0.05). Further multivariate analysis showed that infection, transverse myelitis, moderate to severe anemia, thrombocytopenia were associated with poor prognosis of NPSLE (P <0.05), and were independent risk factors.CTX application was associated with improvement of NPSLE prognosis (P < 0.05), is an independent protective factor. Conclusions Infection, transverse myelitis, reduction of blood meal and moderate to severe anemia are risk factors of NPSLE after cranial hemorrhage, suggesting that the prognosis is poor. The application of CTX is a protective factor in disease prognosis, which can improve the survival rate of patients with NPSLE. application.