Clinical analysis of postmenopausal patients with new-onset systemic lupus erythematosus
Objective To explore the clinical characteristics of postmenopausal patients with new-onset systemic lupus erythematosus(SLE).Methods The medical records of 289 patients with SLE in this hospital January 2015 to March 2021 were analyzed retrospectively.The patients were divided into the menopausal group(n=56)and the childbearing age group(n=205)according to whether they were menopausal at the time of onset.Male patients were divided into the male group(n=28).The differences in initial symptoms,clinical manifestations,laboratory indexes and SLE disease activity index(SLEDAI)scores among the three group were analyzed and compared.Results In the menopausal group,there were 5 cases aged 40-＜50 years old,31 cases aged 50-＜60 years old,14 cases aged 60-＜70 years old,and six cases aged ≥70 years old.37 cases occurred more than five years after menopause.Compared with the childbearing age group,the menopa-usal group had an older age of onset,a higher number of other diseases at the time of onset,a higher incidence of fever,edema,chest tightness and urgency as the first symptoms,weight loss,fatigue,myalgia and myasthe-nia,and a lower incidence of rash,kidney damage,WBC reduction,hemoglobin reduction,and of complement C3 and C4 reduction.The proportion of patients with SLEDAI score and SLEDAI score＞20 was lower(P＜0.05).Compared with the male group,the age of onset was older in the menopausal group,and the incidence of fever,edema,chest tightness and urgency as the first symptoms was higher,as well as the incidence of weight loss,myalgia and myasthenia,while the incidence of urinary surface foam as the first symptom and kid-ney damage were lower(P＜0.05).The most common laboratory abnormalities in postmenopausal group were ANA ≥1∶80,followed by anti-nucleosome antibody(+),anti-DS-DNA antibody(+),increased eryth-rocyte sedimentation rate,and decreased complement C3.Multivariate logistic regression analysis showed that compared with the menopause group,the risk of weight loss,myalgia and myasthenia was lower in the child-bearing age group,and the risk of kidney damage was higher(P＜0.05).Compared with the menopausal group,the male group had a higher risk of renal damage and a lower risk of complement C4 reduction(P＜0.05).Conclusion The first symptoms and clinical manifestations of postmenopausal SLE patients are atypi-cal,the organ damage is mild,and SLEDAI is low.
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