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原发性干燥综合征合并肝功能损害患者的临床特点及危险因素分析

Clinical characteristics and risk factors of primary Sj?gren's syndrome with liver function damage

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目的 分析原发性干燥综合征(pSS)合并肝功能及多系统损害患者的临床特征,以探究pSS肝功能损害的危险因素,为临床诊治提供新依据.方法 选取2020年1月-2023年10月就诊于中国人民解放军联勤保障部队第920医院的92例确诊为pSS合并肝功能损害的患者为肝损组,另选取92例无肝功能损害的pSS患者作为非肝损组,分别收集2组患者的临床资料、辅助检查结果并行对比分析.结果 pSS肝损组合并血液系统受累(56.5%,52/92)、骨关节受累(54.3%,50/92)及甲状腺受累(23.9%,22/92)者均显著多于pSS非肝损组[34.8%(32/92)、32.6%(30/92)、8.7%(8/92),P<0.05];肝损组合并2个以上系统受累(73.9%,68/92)者亦显著多于非肝损组[55.4%(51/92),P<0.05].pSS 肝损组 CRP[6.45(2.83,17.10)mg/L]、WBC[6.28(4.37,9.51)× 109/L]水平均显著高于非肝损组[2.45(0.80,8.40)mg/L、5.31(4.14,6.74)×109/L,P<0.05].pSS 肝损组 ANA阳性率(84.8%,78/92)、抗 SSB 阳性率(50.0%,46/92)均显著高于 pSS 非肝损组[65.2%(60/92)、28.3%(26/92),P<0.05].Logistic 回归分析显示,高 CRP(OR=1.037,95%CI:1.003~1.071,P<0.05)、高 WBC(OR=1.325,95%CI:1.139~1.542,P<0.01)、多系统受累(OR=2.262,95%CI:1.039~4.925,P<0.05)均为 pSS 患者合并肝功能损害的危险因素.结论 肝功能损害的pSS患者常伴有多个系统损害,高CRP、WBC水平以及多系统受累均为pSS肝功能损害的危险因素.
Objective To analyze the clinical characteristics of patients with primary Sjögren's syndrome(pSS)compli-cated with liver function and multi-system damage,and to explore the risk factors of liver function damage in pSS,so as to provide new basis for clinical diagnosis and treatment.Methods A total of 92 patients diagnosed with PSS and liver function damage admitted to the 920th Hospital of the Joint Logistics Support Force of PLA from January 2020 to October 2023 were selected as liver injury groups,and 92 patients with PSS patients who has no liver damage were selected as non-liver injury groups.The clinical data and auxiliary examination results of the two groups of patients were collated for comparison and analysis.Results The combination of liver damage and blood system involvement(56.5%,52/92),joint and bone involvement(54.3%,50/92),and thyroid involvement(23.9%,22/92)in patients with pSS is signifi-cantly higher than in patients with pSS,however,without liver damage[34.8%(32/92),32.6%(30/92),8.7%(8/92),P<0.05].The proportion of patients with involvement of two or more systems in the liver injury group(73.9%,68/92)is also significantly higher than that in the non-liver injury group(55.4%,51/92,P<0.05).The levels of CRP[6.45(2.83,17.10)mg/L]and WBC[6.28(4.37,9.51)×109/L]in the pSS liver lesion group were found to be significantly higher than those in the non-liver injury group[2.45(0.80,8.40)mg/L,5.31(4.14,6.74)×109/L,P<0.05].The positive rates of ANA(84.8%,78/92)and anti-SSB(50.0%,46/92)in the pSS liver injury group were significantly higher than those in the pSS non-liver injury group[65.2%(60/92)and 28.3%(26/92),respectively,P<0.05].The logistic regression analysis demonstrated that elevated CRP(OR=1.037,95%CI:1.003-1.071,P<0.05)and elevated WBC(OR=1.325,95%CI:1.139-1.542,P<O.01),multi-system involvement(OR=2.262,95%CI:1.039-4.925,P<0.05)were risk factors for liver function damage in pSS patients.Conclusion Patients with pSS who also have impaired liver function are frequently accompanied by multiple system im-pairment.Elevated CRP and WBC levels,in conjunction with multi-system involvement,constitute risk factors for pSS-related liver dysfunction.

Sjögren's syndromeLiver function impairmentMultisystem damage

高官莉、魏晓龙、申东北、张应璐、张树荣

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中国人民解放军联勤保障部队第920医院、昆明医科大学第920医院临床学院消化内科,云南 昆明 650032

昆明医科大学研究生院,云南 昆明 650500

干燥综合征 肝功能损害 多系统损害

2024

中华全科医学
中华预防医学会,安徽省全科医学会

中华全科医学

CSTPCD
影响因子:1.688
ISSN:1674-4152
年,卷(期):2024.22(12)