目的:本研究旨在调查有和无神经精神性系统性红斑狼疮(NPSLE)患者在临床特征和自身抗体模式上的差异,并确定中国人群中与NPSLE相关的危险因素。
方法:对两家三级医院的SLE患者进行回顾性分析。探讨了NPSLE与免疫学生物标志物之间的关系。
结果:在945例SLE患者中,75例(7.94%)被诊断为NPSLE。最普遍的NP表现涉及认知障碍(30.67%),头痛(26.67%),癫痫症(26.67%),和精神病(26.67%)。我们观察到精神病和抗β2GPI抗体之间的显著关联(F=6.092,p=0.015),多发性神经病和抗Scl70抗体(F=20.161,p<0.001),脱髓鞘综合征和抗心磷脂抗体(F=6.637,p=0.011),重症肌无力和抗RNP(F=5.864,p=0.017),和抗-Smith抗体(F=5.096,p=0.026)。多因素物流分析显示,抗凝血酶原(aPT)IgM抗体(OR=10.985,CI1.279-94.343,p=0.029),年龄(OR=1.169,CI1.032-1.325,p=0.014),血肌酐(SCr)(OR=1.014,CI1.003~1.025,p=0.009)是NPSLE的独立危险因素,而抗干燥综合征抗原B(SSB)抗体(OR0.023,CI0.002-0.622,p=0.023)和高补体C3(OR=0.001,CI0-0.045,p<0.001)表明NPSLE风险降低。
结论:发现SLE的各种神经精神表现与特异性自身抗体相关。NPSLE的独立危险因素包括aPTIgM抗体,年龄,血清肌酐升高,而缺乏抗SSB抗体和低补体C3水平与风险增加相关。
结论:•发现特异性自身抗体与神经精神症状之间存在显著关联,揭示潜在的生物标志物,以预测和理解NPSLE。•该研究确定了中国人群中NPSLE的独立危险因素,包括抗凝血酶原IgM抗体的存在,年龄较大,血清肌酐升高,和较低的补体C3水平。
OBJECTIVE: This study aimed to investigate disparities in clinical profiles and autoantibody patterns between patients with and without neuropsychiatric systemic lupus erythematosus (NPSLE) in a cohort and to identify risk factors associated with NPSLE in the Chinese population.
METHODS: SLE patients were retrospectively reviewed from two tertiary hospitals. The relationships between NPSLE and immunological biomarkers were explored.
RESULTS: Among the 945 SLE patients, 75 (7.94%) were diagnosed with NPSLE. The most prevalent NP manifestations involved cognitive disorder (30.67%), headache (26.67%), seizure disorder (26.67%), and psychosis (26.67%).We observed significant associations between psychosis and anti-β2GPI antibodies (F = 6.092, p = 0.015), polyneuropathy and anti-Scl70 antibodies (F = 20.161, p < 0.001), demyelinating syndrome and anti-cardiolipin antibodies (F = 6.637, p = 0.011), myasthenia gravis and anti-RNP (F = 5.864, p = 0.017), and anti-Smith antibodies (F = 5.096, p = 0.026). Multivariate logistics analysis showed that anti-prothrombin (aPT) IgM antibodies (OR = 10.985, CI 1.279-94.343, p = 0.029), age (OR = 1.169, CI 1.032-1.325, p = 0.014), and serum creatinine (SCr) (OR = 1.014, CI 1.003-1.025, p = 0.009) were independent risk factors of NPSLE, while anti-Sjogren syndrome antigen B (SSB) antibodies (OR 0.023, CI 0.002-0.622, p = 0.023) and high complement C3 (OR = 0.001, CI 0-0.045, p < 0.001) indicated reduced risk of NPSLE.
CONCLUSIONS: Various neuropsychiatric manifestations in SLE were found to be correlated with specific autoantibodies. Independent risk factors for NPSLE included aPT IgM antibodies, age, and elevated serum creatinine, while the absence of anti-SSB antibodies and low complement C3 levels were associated with increased risk.
CONCLUSIONS: •Significant associations were found between specific autoantibodies and neuropsychiatric symptoms, shedding light on potential biomarkers for predicting and understanding NPSLE. •The study identifies independent risk factors for NPSLE in the Chinese population, including the presence of anti-prothrombin IgM antibodies, older age, elevated serum creatinine, and lower complement C3 levels.