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ObjectiveTo investigate the association of complement C3 with clinical and serological features of patients with systemic lupus erythematosus.MethodsData was collected by the same methods in the past ten years in fifteen hospitals in Jiangsu Province and then data weres summarized for retrospective analysis.Clinical and laboratory data were selected and then analyzed by Chi-square test,Wilcoxon rank sum test and Logistic regression.ResultsOne thousand four hundred and five patients were investigated.One thousand and forty two had low serum complement C3 level.In this case control study,hospitalization age,disease course,admission times,pleurisy,gastrointestinal involvement,general lymphadenopathy/hepatosplenomegaly,white blood cell count, haemoglobin level,platelet count, serum C-reactive protein level,serum albumin level,serum creatinine level,Urine protein quantification,anti-nuclear antibodies (ANA),anti-dsDNAantibodies, anti-SmantibodiesandSLEDAIscore were possible factors associatedwith complement C3 reduction(P＜0.05).Logistic regression analysis showed that CRP (OR=0.396,0.254-0.617,P=0.000),ANA (OR=2.907,1.267-6.670,P=0.012),urine protein level(OR=1.702,1.043-2.779,P=0.033) and SLEDAI score (OR-0.930, 0.886-0.975,P-0.003) were correlated with complement C3 reduction.Conclusion Complement C3 level is valuable for lupus flare assessment.The complement C3 reduction is a risk factor for renal impairment.
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Objective To explore the relationship between the impairment of hematological system and disease activity,immunological parameters,and the prognosis of systemic lupus erythematosus (SLE).Methods The clinical and laboratory data of in-patients with SLE in Jiangsu Province were investigated and all patients were hospitalized between 1999-2009.The impairment of hematological system was assessed and the relationship between hematological system damage and disease activity,immunological parameters,mortality rate of patients with SLE were analyzed.Statistic method used was X2 test.Results One thousand nine hundred and fifty eight cases of SLE were included in the study,in which,1836 were female and 122 were male.One thousand five hundred and forty nine (79.1%) patients complicated with hematological system damage,62.3% were anemia,45.5% with leucopenia and 29.4% with thrombocytopenia.There were significant differences in hematological system damage rate among patients with mild activity group,moderate activity group,severe activity group and almost no activity group,compared respectively with almost no activity group.The P values were P=0.01 and P＜0.01 respectively.The incidence of hematological system damage in elevated ESR,low complement C3 level,anti-dsDNA antibody group was higher than that in patients who had normal ESR,complement C3 level and anti-dsDNA group.(P＜0.01).During follow-up,166 patients died,of which the mortality rate(91.6%) in patients had hematological system damage,was obviously higher than those without hematological damage(8.4%)(P＜0.01 ).Among the 166 deceased patients,38.6% died of severe infection,22.9% died ofrenal failure,15.1% died ofnervous system damage,10.2% died of cadiovascular damage and 13.3% died from other causes.Conclusion Hematological system is one of the most commonly involved system in patients with SLE,of which anemia is the most common,and the incidence of leukopenia follows.The impairment of hematological system is closely related to lupus activity.Patients with abnormal immune parameters tend to have secondary hematological system damage.Severe infection is the main cause of death in patients with lupus,followed by nervous system damage and kidney damage.The mortality rate in patients with lupus that complicated hematological system damage is higher than patients who have no hematological system damage.
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Objective To investigate the initial manifestation and disease onset feature of systemic lupus erythematosus(SLE) in the past ten years in fifteen hospitals in Jiangsu Province.Methods Data was collected by the same Methodsin all the participated hospitals and then it was summarized for retrospective analysis.Two groups were compared by chi-square test.Results ① One thousand nine hundred and fifty eight patients were investigated and the male-to-female ratio was 1∶15.0.② One thousand seven hundred and ninty eight patients had clear initial manifestations.The most common initial manifestations were skin and mucosal lesions(769 cases,42.8％ ) and arthritis (697 cases,38.8％ ).The main skin lesion was malar rash (706 cases).Arthritis was found to be more common in female than male.③ All hospitalized patients at their first admission showed multiple organ/system involvement:the most common involvement was skin and mucous membrane (82.3％),hematologic damage (74.0％),in which at least one series of blood cells were involved,arthritis (1156 cases,56.5％ ) much more than myositis (51 cases),proteinuria 1046 cases and hematuria in 385 cases.Renal biopsy pathology showed type Ⅳ glomerulonephritis.Conclusion ① SLE patients are mainly female and the male to female ratio is 1∶15.0.② The most common initial manifestations are skin and mucosal lesions.③ The most commonly involved organ/system are skin and mucous membrane,blood,joint and kidney.The most common pathological changes shown in renal biopsy is type Ⅳ glomerulonephritis.
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ObjectiveTo study B-cell activating factor(BAFF)/a proliferation inducing ligand (APRIL)protein and mRNA expression levels in patients with primary Sj(o)gren's syndrome(pSS)and its contribution to the pathogenesis of pSS.Methotis The levels of serum BAFF and APRIL were tested by ELISA method in 32 pSS patients and compared with 23 healthy control sabjects.BAFF/APRIL protein levels of labial salivary glands were examined in 17 pSS patients by immunohistochemical staining and compared with 8 healthy controls.BAFF/APRIL mRNA expression relative levels to GAPDH of PBMC were also detected in 18 pSS patients by real time RT-PCR and compared with 20 healthy controls.The relationship between BAFF/APRIL levels and several clinical manifestations in pSS patients were analyzed.Results The median level of serum BAFF in pSS were markedly higher than that in healthy controls[(7.4±3.9)ng/ml vs(3.7±1.1)ng/ml,P＜0.01].Serum APRIL levels were also significantly elevated compared to healthy controls[(26±15)ng/ml vs(16±15)ng/ml,P=0.039].The higher levels of BAFF were associated with higher levels of IgG,ESR.total globulin and the titer of ANA(P＜0.05).There was a positive correlation between serum APRIL levels and ESR and labial salivary gland lymphocyte focus scores(P＜0.05).The two cytokines levels inversely correlated with the count of peripheral white blood cells and platelets in pSS(P＜0.05).When comparing serum Ievels of APRIL and BAFF in patients with pSS,a positive correlation could be found(r=0.534,P=0.002).The BAFF/APRIL protein levels were higher in infiltrating lymphocytes of labial salivary glands from pSS patients than from the controls(P＜0.05).The BAFF mRNA[(0.023±0.024)vs(0.245±0.188),P＜0.01]and APRIL mRNA[(0.047±0.035)vs(0.130±0.097),P=0.002]levels of PBMC were significantly lower in pSS patients than in the normal controls.Conclusion The BAFF/APRIL levels of serum and labial salivary glands are significantly elevated in patients with pSS and correlate with clinical parameters.These indicate that BAFF and APRIL may be involved in the pathogenesis of pSS.The low BAFF mRNA and APRIL mRNA levels of PBMC in pSS may reveal that the production and regulation of this system is complicated.
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Objective To explore the association between serum cartilage oligomeric matrix protein (COMe) levels and joint destruction in rheumatoid arthritis (RA) and inflammatory arthritis patients. Methods Serum level of COMP was measured with ELISA in 154 arthritis patients.The results of serum COMe were compared with clinical parameters and the modified SHARe scores after 2 years in RA patients. Results Serum COMP level of RA patients was higher than that of normal controls and patients with other forms of arthritis in which only synovial membrane was involved (P＜0.05).We found a significant difference between sCOMP in osteoarthritis (OA) and psoriatic arthritis (PSA) patients with normal controls ,but not with other forms of arthritis.There was no difference of sCOMP between RA,OA or PSA patients.We found a positive correlation between baseline sCOMP and deterioration of modified SHARP scores after 2 years (P＜ 0.001,r=0.848),but did not find correlation between the baseline sCOMP and the titer of anti-CCP,RF, grade of joint function and modified SHARP scores at baseline.We also found a significant correlation between sCOMP and ESR or CRP levels,duration of morning stiffness,joint swelling scores and tenderness scores re spoctively (P＜0.05).Conclusion Serum COMP level is elevated in arthritis patients whose joint cartilage is also involved,particularly in patients with RA.The results of this study indicate that serum COMe may be used as a diagnostic and prognostic marker for cartilage destruction in established RA patients.
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Objective To study the association of serum cartilage oligomeric matrix protein (COMP)with disease activity and early joint destruction of rheumatoid arthritis (RA). Methods The serum levels of COMP were measured with ELISA in 94 patients with RA and 40 controls. The serum level of erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (ACCP) and hand X-ray were examined at the same time. Results Significantly increased serum level of COMP was found in RA patients (11.3±5.2) U/L as compared to that in healthy controls (9.2±1.7) U/L (P=0.017).Serum level of COMP was higher in 64 active patients (14±6) U/L than that in 30 inactive disease (9±4) U/L(P=0.005). COMP level was positively correlated with the number of the affected joints, X-ray stage, CRP and ESR level (P<0.05); but had no correlation with age, disease course, grade of joint function, RF and ACCP levels. Thirty patients were followed for two years and their radiographic changes were evaluated at the baseline and the end of this study. Sixteen of 18 patients with high concentration serum COMP level had radi-ologic progression, but only 5 of 12 patients with no increase of serum COMP had radiologic progression. A significant difference (P=0.013) was founded in the two groups. Conclusion The present data suggests that the level of COMP is high in patients with RA. High serum levels of COMP indicate high disease activity and early progressive of bone destruction in RA patients. We can us COMP as a laboratory marker of RA.
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Objective To investigate the urinary tract infection by Mycoplasma in systemic lupus erythematosus (SLE) patients. Methods Mycoplasma hominis (Mh) and Ureaplasma urealyticum (Uu) from serum, eye, pharynx and urethra secretions were detected by nested polymerase chain reaction (nPCR) in 129 SLE patients, and DNA sequences of positive product were detected and analysed. Results Seventy-nine were positive and 50 were negative, 50 of 79 positive subjects (63.2%) were urinary tract infection, and 11 of 50 negative subjects (22.0%) were infected (P=0.001). Ninty-five active SLE patients, 66(69%) were positive and 29(30.5%) were negative for mycoplasma infection. Thirty-four inactive SLE patients, 13(38%) were positive and 21(61.7%) were negative for mycoplasma infection (P=0.000). Comparing these two setsof patients, the urinary tract infection in the active SLE was significantly higher than in stable patients. Conclusion Mycoplasma infection is the major pathogen inducing SLE flare and may be one of the infective pathogene of SLE.
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Objective To study the clinical value of HRCT in staging of lung interstitial disease(LID) in connective tissue disease(CTD).Methods 222 patients with CTD confirmed clinically underwent HRCT scan.The staging of LID according to the HRCT features of LID were done and the therapeutic effect was compared between each stage.Results In 222 cases ,64 cases were negative on HRCT as stage 0,158 cases had disseminated LID in different degree,including stage Ⅰ in 107,stage Ⅱ in 36 and stage Ⅲ in 15.There were significant statistically between the therapeutic effect and staging of LID.Conclusion The staging of CTD with LID by HRCT is helpful for judging the extent of LID and clinical treatment.
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Objective To investigate the prevalence and clinical features of tuberculosis (TB) infection in patients with systemic lupus erythematosus (SLE). Methods Four hundred and twenty-six patients with SLE in our hospital from 1991 to 2004 were analyzed. Results TB was found in 18/426 (4.2%) patients and 7 (39%) of them died. The morbidity and mortality was obviously higher than in normal peoples. Of all 18 patients, 12, 3, 3 cases suffered pulmonary tuberculosis, tuberculo-meningitis and lymphy node tuberculosis respectively. Tuberculin test was strong positive in 2/18 (12.5%) patients and negative in 16/18 (87.5%) patients. The negative rate was significantly higher compared with normal peoples. Fifteen (83%) cases were diagnosed TB infection after taken immunosuppressive agents for 6～36 months. Conclusion Because of long-term immunosuppressive agents therapy, patients with SLE are prone to tuberculosis infection. The clinical manifestation is not always typical and the morbidity and mortality is high. Early detection of TB infection is important.