Clinical application of 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus
10.3760/cma.j.cn441217-20200907-00117
- VernacularTitle:2019年欧洲抗风湿病联盟/美国风湿病学会系统性红斑狼疮分类标准的临床应用分析
- Author:
Yunjie GAO
1
;
Huijing WANG
;
Fanghao CAI
;
Yanhong MA
;
Lan LAN
;
Pingping REN
;
Yaomin WANG
;
Xiaoqi SHEN
;
Jianghua CHEN
;
Fei HAN
Author Information
1. 浙江大学医学院附属第一医院肾脏病中心，浙江大学肾脏病研究所，浙江省肾脏病防治技术研究重点实验室，杭州 310003
- Keywords:
Lupus erythematosus, systemic;
Prognosis;
Risk factors;
Weight score;
Clinical features
- From:
Chinese Journal of Nephrology
2021;37(10):789-794
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the weight score and clinical application of 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) systemic lupus erythematosus (SLE) classification criteria in lupus nephritis patients.Methods:Lupus nephritis patients with renal biopsy results who were admitted in the First Affiliated Hospital of Zhejiang University College of Medicine between January 2014 and December 2018 were enrolled retrospectively. According to whether these patients were treated with glucocorticoids and/or immunosuppressants at the time of renal biopsy, they were divided into untreated group and post-treatment group. The weight scores were compared between the two groups, and the relationship between each weight score and remission after treatment was analyzed. Taking no remission as the end event, Cox regression analysis was used to analyze the influence of each weighted integral on the end event.Results:A total of 153 patients were enrolled, including 131 (85.6%) females. These were 70 (45.8%) patients in the untreated group and 83 (54.2%) patients in the post-treatment group. The patients in the untreated group had higher scores of fever (>38.3℃), blood system involvement, low complement and positive specific antibodies than those in post-treated group (all P<0.05). In a median follow-up of 34 (6-50) months, 99 patients (64.7%) achieved complete remission, 38 patients (24.8%) achieved partial remission and 16 patients (10.5%) had no remission. With no remission as the endpoint event, univariate Cox regression analysis showed that proliferative lupus nephritis (renal score of 10 points vs 8 points) and neuropsychiatric involvement were the risk factors (both P<0.05), while multivariate Cox regression analysis showed that neuropsychiatric involvement ( HR=4.758, 95% CI 1.324-17.101, P=0.017) was an independent risk factor. Conclusion:The weight scores of 2019 EULAR/ACR SLE classification diagnostic criteria have certain predictive value for remission of patients with lupus nephritis.
