合并过敏性鼻炎对儿童系统性红斑狼疮病情及治疗的影响

Effect of allergic rhinitis on disease condition and treatment in patients with juvenile-onset systemic lupus erythematosus

摘要:

目的 探讨过敏性鼻炎（AR）及其干预对儿童系统性红斑狼疮（JSLE）病情和治疗用药的影响。方法 收集96例确诊的JSLE患儿临床资料，按是否合并过敏性鼻炎或其他过敏性疾病分为过敏性鼻炎组（44例）和非鼻炎过敏组（20例），以及非过敏组（32例），过敏性鼻炎组又随机分为鼻炎干预组和非干预组（各22例）。所有患儿均进行规范JSLE治疗。比较各组患儿的SLE疾病活动性指数（SLEDAI）和激素、免疫抑制剂用药情况。结果 合并过敏性鼻炎组和非鼻炎过敏组的JSLE患儿治疗前的SLEDAI评分、糖皮质激素日累积剂量、免疫抑制剂用药种数均高于非过敏组（P < 0.05），而过敏性鼻炎组和非鼻炎过敏组间的差异无统计学意义（P > 0.05）。治疗1个月后，JSLE合并过敏性鼻炎患儿干预组的SLEDAI评分及激素日累积剂量低于非干预组（P < 0.05），两组患儿免疫抑制剂用药种数的差异无统计学意义（P > 0.05）；治疗3个月及6个月后，干预组的SLEDAI评分、激素日累积剂量、免疫抑制剂使用种类均少于非干预组（P < 0.05）。结论 JSLE合并AR等过敏性疾病可能对SLE病情及治疗产生不利影响；针对AR给予干预有利于病情控制。

Abstract:

Objective To investigate the effect of allergic rhinitis (AR) and its intervention on disease condition and medications in patients with juvenile-onset systemic lupus erythematosus (JSLE). Methods The clinical data of 96 children diagnosed with JSLE were collected, and according to the presence or absence of AR or other allergic diseases, they were divided into AR group (n=44), non-AR group (n=20), and non-allergic group (n=32). The children in the AR group were randomly administered with or without intervention (n=22 each). All the children were given standard JSLE treatment. The systemic lupus erythematosus disease active index (SLEDAI) and application of hormones and immunosuppressants were compared between groups. Results The AR and non-AR groups had significantly higher SLEDAI scores, daily cumulative doses of glucocorticoids, and number of types of immunosuppressants used than the non-allergic group before treatment (P < 0.05), while there were no significant differences between the AR and non-AR groups (P > 0.05). After one month of treatment, the AR group with intervention had significantly lower SLEDAI scores and daily cumulative doses of glucocorticoids than the AR group without intervention (P < 0.05), while there was no significant difference in the application of immunosuppressants between these two groups (P > 0.05). After 3 and 6 months of treatment, the AR group with intervention had significantly lower SLEDAI scores, daily cumulative doses of glucocorticoids, and number of types of immunosuppressants than the AR group without intervention (P < 0.05). Conclusions JSLE combined with allergic diseases such as AR has an adverse effect on disease condition and treatment, and the intervention for AR helps with the control of JSLE.