4.4 Article

Clinical Study on Systemic Lupus Erythematosus Complicated with Knee Bone Infarction

Journal

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE
Volume 2022, Issue -, Pages -

Publisher

WILEY-HINDAWI
DOI: 10.1155/2022/7025811

Keywords

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Funding

  1. Medical and Health Technology Development Foundation of Shandong Province [2018WS018]
  2. TCM Science and Technology Development Foundation of Shandong Province [2019-0615]

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This study analyzed the clinical characteristics and influencing factors of knee bone infarction in patients with systemic lupus erythematosus (SLE). The research found that the risk of knee bone infarction was higher in patients with SLE within a 5-year disease course and in young patients. Risk factors included Raynaud's phenomenon, anti-nRNP antibody positivity, and early high-dose glucocorticoid therapy.
Objective. The present study aims to (1) analyze the clinical characteristics and related influencing factors of knee bone infarction in systemic lupus erythematosus (SLE) and (2) improve the understanding of SLE complicated with knee bone infarction. Methods. The data of patients with SLE complicated with knee bone infarction were retrospectively analysed; patients with SLE during the same period who matched in age, gender, and disease duration were selected as control subjects, with a 1 : 1 ratio with the SLE group. The clinical data were collected to analyze the risk factors for SLE complicated with knee bone infarction. Results. In a total of 36 (6.4%) of 563 patients aged 19-33 (25.8 & PLUSMN; 4.8) years who had SLE during the same period, the disease was complicated with knee bone infarction. The diagnosis of knee bone infarction was made at an SLE duration of 7-65 (26.2 +/- 15.7) months. During the SLE course, knee bone infarction occurred within 1 year in 6 cases (16.7%), within 1-5 years in 28 cases (77.8%), and in > 5 years in 2 cases (5.6%). Raynaud's phenomenon incidence and anti-nRNP antibody positivity were significantly higher in the knee bone infarction group than in the control group (P < 0.01 and P < 0.05, respectively). The cumulative glucocorticoid dose at 1, 3, and 6 months was significantly higher in the knee bone infarction group than in the control group (P < 0.05). SLE complicated with knee necrosis had a statistically significant rank correlation with Raynaud's phenomenon (r = 0.445, P < 0.001), anti-nRNP antibody (r = 0.309, P=0.008), and renal injury (r = 0.252, P=0.032). The multivariate analysis of SLE complicated with knee bone infarction showed that Raynaud's phenomenon was an independent influencing factor for the complicated knee bone infarction in SLE patients (OR = 4.938, P=0.004), and the probability of SLE complicated with knee bone infarction in Raynaud's phenomenon positive patients was 4.938 times that of Raynaud's phenomenon negative patients. Conclusions. The risk of knee bone infarction was relatively high in patients with SLE within a 5-year disease course and in young patients. The risk factors were Raynaud's phenomenon, anti-nRNP antibody positivity, and early high-dose glucocorticoid therapy.

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