Clinical study of 20 patients with neuropsychiatric systemic lupus erythematosus

Abstract:

Objective：To analyze the clinical characteristics of neuropsychiatric systemic lupus erythematosus（NPSLE） and explore the hazardous factor of this disease. Methods：A total of 20 NPSLE patients hospitalized in The Second Affiliated Hospital of Chongqing Medical University from January 2016 to December 2020 were taken as the research group. The neuropsychiatric symptoms，cerebrospinal fluid，brain MRI，treatment protocols and prognosis of 20 NPSLE patients were statistically analyzed. A total of 20 patients with systemic lupus erythematosus（SLE） during the same period were taken as the control group. Two sets of laboratory indicators as well as laboratory indicators before and after treatment of the research group were compared. Logistic regression analysis was performed on the related risk factors of NPSLE. Results：Compared with the control group，the anti-C1q antibody and the anti-ds-DNA antibody of the research group increased（P=0.001，0.005）；C3，C4 and serum albumin/globumin（A/G） reduced（P=0.000，0.016，0.001）. Compared with anti-C1q antibody，anti-ds-DNA antibody，immune globulin IgA and immune globulin IgG of the research group before treatment and these laboratory indicators after treatment reduced（P=0.000，0.001，0.006，0.000）；C3，C4 and A/G increased（P=0.000，0.000，0.000）. The univariate logistics regression analysis indicated that A/G，anti-ds-DNA antibody，C3 and C4 were related to NPSLE. The multivariate logistics regression analysis indicated that C3 was related to NPSLE（OR=0.000，95%CI=0.000-0.417，P=0.034）. Conclusion：Compared with SLE，C1q antibody and anti-ds-DNA antibody of NPSLE patients are increased，and their titer decreases after treatment；C3，C4 and A/G are decreased，and their indexes increase after treatment. The indexes of immunoglobulin IgA and immunoglobulin IgG in NPSLE patients decrease after treatment. Anti-C1q antibody，anti-ds-DNA antibody，C3，C4，A/G，immune globulin IgA and immune globulin IgG are closely correlated with NPSLE，and they are key indicators reflecting the activity of NPSLE. Decline in C3 is an independent risk factor for NPSLE.