Volume 22 Issue 5
May  2024
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LEI Jiamin, HOU Ruihong, MI Liangyu, ZHANG Liyun, GAO Jinfang, XU Ke. Influencing factors analysis of systemic lupus erythematosus with osteonecrosis[J]. Chinese Journal of General Practice, 2024, 22(5): 750-753. doi: 10.16766/j.cnki.issn.1674-4152.003495
Citation: LEI Jiamin, HOU Ruihong, MI Liangyu, ZHANG Liyun, GAO Jinfang, XU Ke. Influencing factors analysis of systemic lupus erythematosus with osteonecrosis[J]. Chinese Journal of General Practice, 2024, 22(5): 750-753. doi: 10.16766/j.cnki.issn.1674-4152.003495

Influencing factors analysis of systemic lupus erythematosus with osteonecrosis

doi: 10.16766/j.cnki.issn.1674-4152.003495
Funds:

 82271761

  • Received Date: 2023-07-18
    Available Online: 2024-07-20
  •   Objective  To analyze the factors associated with osteonecrosis (ON) in patients with systemic lupus erythematosus (SLE) in order to reduce the impact on patients'quality of life.  Methods  A total of 65 SLE patients with ON (ON group) and 65 SLE patients without ON (non-ON group) who hospitalized in the Department of Rheumatology and Immunology of Shanxi Bethune Hospital from January 2013 to December 2022 were selected.The clinical symptoms, laboratory examination and treatment were compared between the two groups.Logistic regression was used to analyze the risk factors for SLE complicated with ON.  Results  Among the case groups, 53 cases (81.5%) were bilateral ON; There were 29 cases (44.6%) of bone pain and 18 cases (27.6%) of complex multiple symptoms.In univariate analysis, there were statistically significant differences in disease course, hormone accumulation time, menopausal history, nervous system involvement and myalgia muscle weakness, and there were statistically significant differences in white blood cell count, percentage of total T cells and suppressor T (Ts) cells, percentage and absolute value of natural killer T (NKT) cells, standardized dilute Russell's viper venom time (dRVVT) ratio, activated partial thromboplastin time, and history of aspirin, statins, bisphosphonates, hydroxychloroquine and immunosuppressants in medication use (P < 0.05).Multivariate logistic regression analysis showed that the percentage of total T cells and the ratio of standardized dRVVT were the influencing factors of SLE with ON.  Conclusion  Appropriate use of immunosuppressants, attention to balancing medication interactions in SLE treatment, and special attention to patients with nervous system involvement and muscle pain and weakness.Ts cells in the lymphocyte subpopulation play an important regulatory role in ON.Individuals with higher standardized dRVVT ratios are more likely to have ON or may predict the occurrence of ON.Therefore, caution should be used in clinical diagnosis and treatment.

     

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  • [1]
    张嵩, 谢长好, 陈琳洁. 女性系统性红斑狼疮合并膝关节骨梗死的临床分析[J]. 中华全科医学, 2020, 18(7): 1103-1106. doi: 10.16766/j.cnki.issn.1674-4152.001439

    HANG S, XIE C H, CHEN L J. Clinical analysis of bone infarction of knee joint with female systemic lupus erythematosus[J]. Chinese Journal of General Practice, 2020, 18(7): 1103-1106. doi: 10.16766/j.cnki.issn.1674-4152.001439
    [2]
    KANEKO K, CHEN H, KAUFMAN M, et al. Glucocorticoid-induced osteonecrosis in systemic lupus erythematosus patients[J]. Clin Transl Med, 2021, 11(10): e526. DOI: 10.1002/ctm2.526.
    [3]
    李宁宁, 陈奕均, 冷晓梅, 等. 系统性红斑狼疮并发骨坏死118例临床特点及危险因素分析[J]. 中华内科杂志, 2021, 60(8): 744-750. doi: 10.3760/cma.j.cn112138-20200916-00818

    LI N N, CHEN Y J, LENG X M. Analysis of clinical characteristics and risk factors of 118 cases of systemic lupus erythematosus complicated with osteonecrosis[J]. Chinese Journal of Internal Medicine, 2021, 60(8): 744-750. doi: 10.3760/cma.j.cn112138-20200916-00818
    [4]
    KALLAS R, LI J, PETRI M. Predictors of osteonecrosis in systemic lupus erythematosus: a prospective cohort study[J]. Arthritis Care Res(Hoboken), 2022, 74(7): 1122-1132. doi: 10.1002/acr.24541
    [5]
    HISADA R, KATO M, OHNISHI N, et al. Antiphospholipid score is a novel risk factor for idiopathic osteonecrosis of the femoral head in patients with systemic lupus erythematosus[J]. Rheumatology(Oxford), 2019, 58(4): 645-649. doi: 10.1093/rheumatology/key365
    [6]
    WEI Q, ZHOU M, LIU J, et al. Relationship between osteonecrosis and antiphospholipid antibodies in patients with systemic lupus erythematosus: a systematic review protocol[J]. BMJ Open, 2021, 11(7): e46163. DOI: 10.1136/bmjopen-2020-046163.
    [7]
    ARINGER M, COSTENBADER K, DAIKH D, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus[J]. Ann Rheum Dis, 2019, 78(9): 1151-1159. DOI: 10.1136/annrheumdis-2018-214819.
    [8]
    GLADMAN D D, IBANEZ D, UROWITZ M B. Systemic lupus erythematosus disease activity index 2000[J]. J Rheumatol, 2002, 29(2): 288-291.
    [9]
    SUN S, WANG Q, GONG Y, et al. Multifocal osteonecrosis affecting all four limbs in systemic lupus erythematosus: a case report[J]. Exp Ther Med, 2019, 18(4): 2475-2478.
    [10]
    LESPASIO M J, SODHI N, MONT M A. Osteonecrosis of the hip: a primer[J]. Perm J, 2019, 23: 18-100.
    [11]
    ZHENG Y, ZHENG Z, ZHANG K, et al. Osteonecrosis in systemic lupus erythematosus: systematic insight from the epidemiology, pathogenesis, diagnosis and management[J]. Autoimmun Rev, 2022, 21(2): 102992. DOI: 10.1016/j.autrev.2021.102992.
    [12]
    LONG Y, ZHANG S, ZHAO J, et al. Risk of osteonecrosis in systemic lupus erythematosus: an 11-year Chinese single-center cohort study[J]. Lupus, 2021, 30(9): 1459-1468. doi: 10.1177/09612033211021166
    [13]
    曲立阳, 李建军. 选择性免疫抑制剂对骨代谢影响的研究进展[J]. 中国医药科学, 2022, 12(11): 57-60. doi: 10.3969/j.issn.2095-0616.2022.11.015

    QYU L Y, LI J J. Research progress on the impacts of selective immunosuppressants on bone metabolism[J]. China Medicine and Pharmacy, 2022, 12(11): 57-60. doi: 10.3969/j.issn.2095-0616.2022.11.015
    [14]
    JIN W, YANG X, LU M. Juvenile-onset multifocal osteonecrosis in systemic lupus erythematosus: a case report[J]. Medicine(Baltimore), 2021, 100(2): e24031. DOI: 10.1097/MD.0000000000024031.
    [15]
    ATTARDO S, MUSUMECI O, VELARDO D, et al. Statins neuromuscular adverse effects[J]. Int J Mol Sci, 2022, 23(15): 8364. DOI: 10.3390/ijms23158364.
    [16]
    CRISAN E, PATIL V K. Neuromuscular complications of statin therapy[J]. Curr Neurol Neurosci Rep, 2020, 20(10): 47. DOI: 10.1007/s11910-020-01064-0.
    [17]
    CAMERINO G M, TARANTINO N, CANFORA I, et al. Statin-induced myopathy: translational studies from preclinical to clinical evidence[J]. Int J Mol Sci, 2021, 22(4): 2070. DOI: 10.3390/ijms22042070.
    [18]
    INDIRLI R, LANZI V, MANTOVANI G, et al. Bone health in functional hypothalamic amenorrhea: what the endocrinologist needs to know[J]. Front Endocrinol(Lausanne), 2022, 13: 946695. DOI: 10.3389/fendo.2022.946695.
    [19]
    HERRADA A A, ESCOBEDO N, IRURETAGOYENA M, et al. Innate immune cells'contribution to systemic lupus erythematosus[J]. Front Immunol, 2019, 10: 772. DOI: 10.3389/fimmu.2019.00772.
    [20]
    MA J, GE J, GAO F, et al. The role of immune regulatory cells in nontraumatic osteonecrosis of the femoral head: a retrospective clinical study[J]. Biomed Res Int, 2019, 2019: 1302015. DOI: 10.1155/2019/1302015.
    [21]
    侯晓睿, 黄钊霞, 易夏玉, 等. NKT细胞在MRSA感染性肺炎中作用的初步研究[J]. 中国免疫学杂志, 2023, 39(9): 1803-1808. doi: 10.3969/j.issn.1000-484X.2023.09.003

    HOU X R, HUANG Z X, YI X Y, et al. Preliminary study on role of NKT cells in MRSA infectious pneumonia[J]. Chinese Journal of Immunology, 2023, 39(9): 1803-1808. doi: 10.3969/j.issn.1000-484X.2023.09.003
    [22]
    ALMEIDA J S, CASANOVA J M, SANTOS-ROSA M, et al. Natural killer T-like cells: immunobiology and role in disease[J]. Int J Mol Sci, 2023, 24(3): 2743. DOI: 10.3390/ijms24032743.
    [23]
    LI J, YU T T, YAN H C, et al. T cells participate in bone remodeling during the rapid palatal expansion[J]. FASEB J, 2020, 34(11): 15327-15337. doi: 10.1096/fj.202001078R
    [24]
    FAVALORO E J, PASALIC L. Lupus anticoagulant testing during anticoagulation, including direct oral anticoagulants[J]. Res Pract Thromb Haemost, 2022, 6(2): e12676. DOI: 10.1002/rth2.12676.
    [25]
    DEVREESE K, DE GROOT P G, DE LAAT B, et al. Guidance from the scientific and standardization committee for lupus anticoagulant/antiphospholipid antibodies of the international society on thrombosis and haemostasis: update of the guidelines for lupus anticoagulant detection and interpretation[J]. J Thromb Haemost, 2020, 18(11): 2828-2839. doi: 10.1111/jth.15047
    [26]
    JIANG W, HU J W, HE X R, et al. Statins: a repurposed drug to fight cancer[J]. J Exp Clin Cancer Res, 2021, 40(1): 241. DOI: 10.1186/s13046-021-02041-2.
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