Clinical characteristics and risk factors of respiratory system involvement in children with systemic lupus erythematosus
10.3760/cma.j.issn.1673-4912.2024.12.005
- VernacularTitle:儿童系统性红斑狼疮呼吸系统受累的临床特征和危险因素分析
- Author:
Ning QU
1
;
Hongtao ZHU
1
Author Information
1. 新疆医科大学第一附属医院儿内三科，乌鲁木齐 841100
- Publication Type:Journal Article
- Keywords:
Systemic lupus erythematosus;
Children;
Respiratory system;
Risk factors
- From:
Chinese Pediatric Emergency Medicine
2024;31(12):905-909
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the clinical characteristics of respiratory system involvement in children with systemic lupus erythematosus (SLE) and explore the risk factors associated with respiratory system involvement in cSLE.Methods:The children with SLE who were hospitalized from March 2016 to March 2023 for the first time in the Department of Pediatrics at the First Affiliated Hospital of Xinjiang Medical University were selected as the research objects. According to whether had respiratory system involvement, they were divided into respiratory system involvement group and non-respiratory system involvement group. The differences of clinical characteristics between the two groups were compared. The risk factors of respiratory system involvement in children with SLE were analyzed by multivariate Logistic regression model, and the predictive value was evaluated by drawing the receiver operating characteristic（ROC）curve.Results:A total of 152 pediatric patients with SLE were included, of which 58(38.1%) cases were in the respiratory system involvement group, and 94(61.8%) cases were in the non-respiratory system involvement group.Compared to the non-respiratory system involvement group, the respiratory system involvement group of pediatric patients with SLE had an older age when onset,a higher systemic lupus erythematosus disease activity index, higher proportions of fever, joint pain, cardiac involvement, and hematological involvement, lower levels of hemoglobin and platelets, higher erythrocyte sedimentation rate and C-reactive protein levels, and a higher positivity rate of anti-dsDNA antibodies. The differences were all statistically significant ( P<0.05). Multivariable Logistic regression analysis showed that older age, cardiac involvement, hematological involvement, and positive anti-dsDNA antibodies were independent risk factors for respiratory system involvement in pediatric patients with SLE ( P<0.05). The area under the ROC curves for age, cardiac involvement, hematological involvement, and positive anti-dsDNA antibodies were 0.607, 0.623, 0.678, and 0.720, respectively. The area under the ROC curve for the combination of the four factors was 0.872, with a sensitivity of 88.3% and a specificity of 70.7%. Conclusion:Pediatric patients with SLE are prone to respiratory system involvement. If the patients have older age at onset, presence of cardiac or hematological involvement, and positive anti-dsDNA antibodies, attention should be paid to the possibility of respiratory system involvement. Close monitoring of symptoms and signs in these patients, conducting relevant examinations promptly, and timely diagnosis and treatment are crucial for improving prognosis.
