血清乳酸脱氢酶水平与原发性干燥综合征患者预后的相关性分析-现代医学

血清乳酸脱氢酶水平与原发性干燥综合征患者预后的相关性分析

单位：南京大学医学院附属鼓楼医院风湿免疫科, 江苏南京 210008

分类号：R593

出版年·卷·期（页码）：2025·53·第五期（828-835）

摘要：

目的： 分析乳酸脱氢酶(LDH)水平与原发性干燥综合征(pSS)患者预后的关系。方法： 纳入2019年1月至2021年12月在本院住院的pSS患者。根据LDH是否大于等于250 U·L^-1分为LDH升高组和LDH正常组，分析两组患者的基线资料和生存资料。结果： 本研究共纳入366例pSS患者，其中LDH升高组99例(27.0%)，LDH正常组267例(73.0%)。与LDH正常组相比，LDH升高组pSS患者出现系统受累多，疾病活动度高，疾病损伤重。随访期间共有25例患者发生死亡。Cox回归分析表明LDH升高是pSS患者全因死亡和肺部感染死亡的危险因素。限制性立方样条图表明LDH作为连续变量与pSS患者死亡之间存在非线性剂量-反应关系(P<0.05)。Kaplan-Meier生存曲线表明LDH升高组患者的生存率低于LDH正常组(P<0.05)。结论： LDH升高的pSS患者合并系统受累多，预后差，该部分患者需密切随访，尤其需关注肺部感染情况。

Objective: To analyze the relationship between lactate dehydrogenase(LDH) level and the prognosis of patients with primary Sjögren's syndrome(pSS). Methods: pSS patients who were admitted to our hospital from January 2019 to December 2021 were included. According to whether the LDH level was no less than 250 U·L^-1, patients were divided into the elevated LDH group and the normal LDH group. The baseline and survival data were compared between the two groups. Results: 366 pSS patients were included in our study, including 99 patients(27.0%) with elevated LDH and 267 patients(73.0%) with normal LDH. Compared with the normal LDH group, patients with elevated LDH had more systemic involvements, higher disease activity and severe disease damage. During the follow-up period, 25 patients died. Cox regression analysis indicated that elevated LDH was a risk factor for all-cause death and pulmonary infection-related death. The restricted cubic spline showed a nonlinear dose-response relationship between LDH as a continuous variable and death(P<0.05). Kaplan-Meier survival curves showed that patients with elevated LDH had a lower survival probability than those with normal LDH(P <0.05). Conclusion: pSS patients with elevated LDH have more systemic involvements and a worse prognosis. Such patients need to be followed closely, with particular attention to pulmonary infection.

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