Systemic lupus erythematosus patients in the low-latitude plateau of China: altitudinal influences
Systemic lupus erythematosus patients in the low-latitude plateau of China: altitudinal influences
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DOI：
10.1177/0961203314544186
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发表时间：
2014-12-01
期刊：
影响因子：
2.6
通讯作者：
Cai, M.
中科院分区：
文献类型：
--
作者：
Qian, G.;Ran, X.;Cai, M.
本研究旨在探讨不同海拔地区系统性红斑狼疮（SLE）住院患者的特征。研究还探讨了SLE活动性与海拔变化之间的相关性。回顾性分析了1029例患者的病历。采用系统性红斑狼疮疾病活动指数（SLEDAI）记录SLE在各器官系统的活动。SLE活动性与海拔高度无显著相关性（r = 0.003, p = 0.159）。高海拔地区SLE患者的发病年龄明显低于低海拔和中海拔地区（p = 0.022和p = 0.004）。低海拔地区SLE入院年龄明显大于中、高海拔地区（p = 0.011, p < 0.001）。高海拔地区患者发病至入院时间较中等海拔地区患者短（p = 0.009）。高海拔地区住院患者Sm抗体阳性率为36.4%，高于中等海拔地区（p = 0.003）。我们发现运动患者的中枢神经系统活动呈增加趋势；不活动患者的免疫活动和肾脏活动与海拔高度相关（p = 0.024, p = 0.004, p = 0.005），而活动患者的关节炎评分随海拔高度的升高呈下降趋势（p = 0.002）。高海拔地区的血红蛋白水平、红细胞和血小板计数显著低于低海拔地区（p < 0.05）。中低海拔组血红蛋白水平差异无统计学意义（p < 0.05）。高原组与中度组血小板计数差异无统计学意义（p < 0.05）。我们的研究结果表明，SLE的一些临床特征、实验室检查和主要器官的活动受到海拔的影响。此外，活动性和非活动性SLE患者的器官活动具有不同的海拔变化模式。这些显著的变化可能揭示了高海拔地区特殊的环境因素可能影响SLE的发展。
The current study was to investigate the features of hospitalized patients with systemic lupus erythematosus (SLE) at different altitudes. The correlation between SLE activity and altitudinal variations was also explored. Medical records of 1029 patients were retrospectively reviewed. Activity of SLE in each organ system was recorded using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). There was no significant correlation between SLE activity and altitudes (r = 0.003, p = 0.159). Age at onset for SLE patients at high altitudes was significantly younger than that at low and moderate altitudes (p = 0.022 and p = 0.004, respectively). Age at SLE admission at low altitudes was significant older than those at moderate and high altitudes (p = 0.011 and p < 0.001, respectively). Patients at high altitudes had shorter duration from disease onset to admission than those at moderate altitudes (p = 0.009). Incidence of Sm antibodies-positive for resident patients at high altitudes was 36.4%, which were higher than that at moderate altitudes (p = 0.003). We found increasing trends of CNS activity in active patients; immunological and renal activities in inactive patients were correlated with elevated altitudes (p = 0.024, p = 0.004, p = 0.005), while arthritis scores in active patients showed the tendency of decreasing with the rise of elevation (p = 0.002). Hemoglobin level, red blood cell and platelet counts at high altitudes were significantly lower than those at low altitudes (p < 0.05, respectively). There was no significant difference in hemoglobin level between moderate-and low-altitude groups (p > 0.05). No significant difference in platelet counts between moderate-and high-altitude groups was observed (p > 0.05). Our findings suggest that some clinical features, laboratory tests and activity of main organs in SLE are influenced by altitudes. Furthermore, organ activities of active and inactive SLE patients have different patterns of altitudinal variations. These distinctive variations likely reveal that peculiar environmental factors at high altitudes can affect the development of SLE.