Clinical characteristics and risk factors of systemic sclerosis with hematologic system damages / 中华风湿病学杂志

ABSTRACT

Objective:To investigate the clinical features, laboratory characteristics and risk factors of systemic sclerosis (SSc) patients with hematologic damages.Methods:The clinical data of 180 SSc patients were collected from January 2010 to April 2020, at the Affiliated Hospital of North Sichuan Medical College. The demographic information, laboratory tests, and clinical symptoms were analyzed retrospectively. Statistical Product and Service Solutions (SPSS) 19.0 was used for t-test, non-parametric Mann-Whitney U test, Chi-squared test, Logistics regression analysis. Results:① Among 180 SSc patients, 70(38.9%) cases were complicated with hematologic damages. Fifty-one (72.9%) cases had anemia, 24 cases (34.3%) had leukopenia, 24 cases (34.3%) had thrombocytopenia, and 22 cases had hematologic damages associated with more than two cell line involvement. ② Clinical symptoms arthritis was significantly higher in the hematologic damage group than patients without( χ2=4.815, P=0.028), however, there was no significant difference in gender, age, disease course, respiratory symptoms, gastrointestinal symptoms, Raynaud's phenomenon, interstitial lung disease and pulmonary hypertension ( P>0.05). ③ Laboratory tests erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) were increased in the hematologic damage group, while the albumin decreased ( Z=-2.448, P=0.014; Z=-2.450, P=0.014; Z=-4.773, P<0.01). The positive rates of anti-dsDNA antibody and anti-ribosomal P protein anti-body was higher in the hematologic damage group ( χ2=5.428, P=0.020; χ2=8.169, P=0.004). ④ Prognosis during follow-up, leukopenia was more likely to recover, while the thrombocytopenia was more difficult to recover. ⑤ Logistics regression analysis showed that positive of anti-ribosomal P protein antibody might bea risk factor for SSc complicated with hematologic damages [ OR=3.930, 95% CI(1.130, 13.666, P=0.031)]. Conclusion:SSc complicated with hematologic damages is common, and patients with hematological damage have more serious clinical symptoms, some of whom have difficulty in recovery. Anti-ribosomal P protein anti-body may be a risk factor for SSc hematologic damages.