rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.14412/1995-4484-2019-166-170rsp-2700Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHГематологические проявления системной красной волчанки в ранней стадии: ассоциация с другими симптомами заболевания и возможное прогностическое значениеHematological manifestations of systemic lupus erythematosus in the early stage: association with other symptoms of the disease and possible prognostic valueПетровА. В.PetrovA. V.

295006, Крым, Симферополь, бульвар Ленина, 5/7

5/7, Lenin Boulevard, Simferopol, Crimea, 295006

petroff14@yandex.ruБелоглазовВ. А.BeloglazovV. A.

295006, Крым, Симферополь, бульвар Ленина, 5/7

5/7, Lenin Boulevard, Simferopol, Crimea, 295006

ШадуроД. В.ShadyroD. V.

295006, Крым, Симферополь, бульвар Ленина, 5/7

5/7, Lenin Boulevard, Simferopol, Crimea, 295006

ГаффароваА. Р.GafarovaA. R.

295006, Крым, Симферополь, бульвар Ленина, 5/7

5/7, Lenin Boulevard, Simferopol, Crimea, 295006

ПетровА. А.PetrovA. A.

295006, Крым, Симферополь, бульвар Ленина, 5/7

5/7, Lenin Boulevard, Simferopol, Crimea, 295006

Медицинская академия им. С.И. Георгиевского ФГАОУ ВО «Крымский федеральный университет им. В.И. Вернадского»РоссияS.I. Georgievsky Medical Academy of the V.I. Vernadsky Crimean Federal UniversityRussian Federation201914052019572166170Copyright © Петров А.В., Белоглазов В.А., Шадуро Д.В., Гаффарова А.Р., Петров А.А., 20192019Петров А.В., Белоглазов В.А., Шадуро Д.В., Гаффарова А.Р., Петров А.А.Petrov A.V., Beloglazov V.A., Shadyro D.V., Gafarova A.R., Petrov A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/2700

Цель исследования – оценка взаимосвязи между выявлением гематологических проявлений системной красной волчанки (СКВ) в ранней стадии заболевания и развитием других синдромов и симптомов заболевания, а также характером и тяжестью повреждения внутренних органов и систем организма в течение последующего пятилетнего периода.

Материал и методы

Материал и методы. Проведен анализ данных клинического наблюдения 89 больных СКВ на протяжении пятилетнего периода. Изучались частота клинических проявлений СКВ, содержание антинуклеарных и антифосфолипидных антител, индекс повреждения SLICC/ACR SDI в зависимости от наличия гематологических проявлений СКВ в дебюте заболевания: лейкопении (ЛП), тромбоцитопении (ТП) и аутоиммунной гемолитической анемии (АГА).

Результаты и обсуждение

Результаты и обсуждение. В дебюте СКВ ЛП наблюдалась у 21,3%, ТП – у 26,9%, АГА – у 8,9% больных. Наличие ЛП ассоциировалось с повышением частоты обнаружения антител к SSA, а ТП – с более частым выявлением антител к Ro-52, кардиолипину и бета-2-гликопротеиду (p<0,05). У больных с ТП в дебюте СКВ по сравнению с пациентами без гематологических проявлений было отмечено повышение (p<0,05) кумулятивной частоты развития в течение пятилетнего периода нефрита (83,3 и 42,9%), поражений центральной нервной системы (70,8 и 26,5%), васкулита (45,8 и 10,2%) и эндокардита Либмана–Сакса (20,8 и 6,1% соответственно), что сопровождалось повышением значений индекса повреждения SLICC/ACR SDI (медиана составила соответственно 2,09 [1,82; 2,21] и 1,12 [0,81; 1,32], p<0,05). У больных с ЛП в дебюте СКВ по сравнению с пациентами без гематологических проявлений была повышена (p<0,05) кумулятивная частота развития пневмонита (15,8 и 6,1%) и синдрома Шегрена (15,7 и 2,0% соответственно).

Заключение

Заключение. Возникновение ТП в дебюте СКВ является предиктором поражения почек, центральной нервной системы, периферических сосудов и клапанного аппарата сердца в течение последующих 5 лет.

Objective

Objective: to assess the relationship between hematological manifestations of systemic lupus erythematosus (SLE) in the early stage of the disease and development of other syndromes and symptoms of the disease, as well as the nature and severity of internal organs damage during the subsequent five-year period.

Subjects and methods

Subjects and methods. The analysis of data of examination of 89 patients with SLE during the five-year period was carried out. The frequency of clinical manifestations of SLE, the level of antinuclear and antiphospholipid antibodies, SLICC/ACR damage index (SDI) depending on the presence of hematological manifestations of SLE in the onset of the disease including leukopenia (LP), thrombocytopenia (TP) and autoimmune hemolytic anemia (AGA) were studied.

Results and discussion

Results and discussion. In the onset of SLE LP was observed in 21.3%, TP – in 26.9%, AGA – in 8.9% of patients. The presence of LP was associated with an increase of antibodies to SSA frequency, and TP – with more frequent detection of antibodies to Ro-52, cardiolipin and β-2-glycoprotein (p<0.05). Patients with TP in the onset of SLE compared with patients without hematological manifestations, had an increase (p<0.05) of the cumulative incidence of nephritis (83.3 and 42.9%), central nervous system lesions (70.8 and 26.5%), vasculitis (45.8 and 10.2%) and Libman-Sachs endocarditis (20.8 and 6.1%, respectively), which was accompanied by an increase of SDI values (median was 2.09 [2, 1.82; 2.21] and 1.12 [0.81; 1.32], p<0.05). In patients with LP, the cumulative incidence of pneumonitis and Sjogren's syndrome was increased in the onset of SLE compared with patients without hematological manifestations (15.8 vs 6.1% and 15.7 vs 2.0%, respectively, p<0.05).

Conclusion

Conclusion. Presence of TP in the onset of SLE is a predictor of kidneys, central nervous system, peripheral vessels and heart valves damage during the next 5 years.

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The authors declare that there are no conflicts of interest present.