系统性红斑狼疮患者凝血—纤溶功能变化与疾病活动的关系OACSTPCD

Objective To observe the changes of coagulation and fibrinolysis function in patients with systemic lu-pus erythematosus(SLE),and to explore their relationships with the disease activity indicators and different system dam-age.Methods Peripheral venous blood was collected from 109 SLE patients and 100 healthy subjects in our hospital.Coagulation-fibrinolytic indexes[activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(FIB),fibrin degradation products(FDP),D-2 polymers(DD)]and SLE disease activity indexes[erythrocyte sedimentation rate(ESR),complement(C)3,C4,anti-double-stranded DNA(anti-dsDNA)antibody,C-reactive protein(CRP),immunoglobulin G(IgG),IgM,and IgA]were detected.The plasma APTT,PT,TT,FIB,FDP,and DD in SLE patients with different disease activity and different system damage were compared.Pearson or Spear-man rank correlation analysis was used to analyze the correlations between APTT,PT,TT,FIB,FDP,DD levels and dis-ease activity indicators.Univariate and multivariate Logistic regression analysis were used to analyze the influencing fac-tors of disease activity in SLE patients.Results Compared with healthy subjects,the levels of PT,FIB,FDP and DD in SLE patients increased(all P<0.05);compared with non-active SLE patients(SLEDAI score<5),SLE patients with ac-tive SLE(SLEDAI score≥5)had higher levels of FIB,FDP and DD(all P<0.05).The levels of FIB,FDP and DD in SLE patients with renal lesions were higher than those without renal lesions(all P<0.05).The plasma FIB level of SLE pa-tients with interstitial lung disease(ILD)was higher than that of patients without ILD(all P<0.05).Compared with pa-tients without serositis,SLE patients with serositis had higher plasma PT,APTT,FDP and DD levels;compared with those without blood system involvement,SLE patients with blood system involvement had longer PT and APTT(both P<0.05).The plasma PT level was positively correlated with ESR and was negatively correlated with C3 in SLE patients(all P<0.05).APTT was positively correlated with ESR,IgG and anti-dsDNA antibody levels,and was negatively correlated with C3 and C4 levels(all P<0.05).FIB was positively correlated with ESR,IgG,C4,IgA and SLEDAI score(all P<0.05).Plasma DD was positively correlated with ESR,CRP,IgG,anti-dsDNA antibody levels and SLEDAI score in SLE patients(all P<0.05).FDP was positively correlated with ESR,CRP,IgG,anti-dsDNA antibody levels and SLEDAI score(all P<0.05).Univariate Logistic regression analysis showed that the increased FIB,ESR,IgA,IgG and anti-dsD-NA antibody and the decreased C3 were the risk factors for SLE disease activity(all P<0.05).Multiple Logistic regression analysis showed that the increased FIB,ESR,IgG and anti-dsDNA antibody levels were the independent risk factors for SLE disease activity(all P<0.05).Conclusions The plasma levels of PT,FIB,DD and FDP increase in SLE patients,and different coagulation-fibrinolysis indexes increase in disease activity groups and patients with different systems im-paired SLE.Increased levels of plasma FIB,ESR,IgG and anti-dsDNA antibody indicate SLE disease activity,and abnor-mal coagulation-fibrinolysis index may indicate the impairment of different systems of SLE.