Abstract:

Objective     To analyze risk factors for osteonecrosis of the femoral head(ONF) patients with systemic lupus erythematosus(SLE).  Methods    SLE-ONF group was made up of 37 female SLE who developed ONF.74 female SLE patients and 30 polymyositis(PM)/dermatomyositis(DM) female pations without ONF were selected randomly from in-patients of the same time as the control groups Univariate analysis and multiple logistic regression analysis were applied for associated impact factors. Results     Univarriate analysis revealed significant differences in the following variables between the two groups: knee pain,  anaemia, SLE disease activity index(SLEDAI), anti-nucleosome  antibodies(AnuA) , anti-SSB antibodies, prothrombin time (PT), activated partial thromboplastin time (APTT), hypersensitive Creactive protein(Hs-CRP), sudden stop of glucocorticoid, the initial prednisolone dose more than 60mg/d, mean daily prednisolone dose more than 60mg/d in the first month, and mean daily dose of the second/third month, 4 th/6th month and 10th/12th month (all P<0.05 or 0.01).  Positive anti-SSB antibodies  was negatively correlated with the occurrence of ONF（P=0.001）. There was no statistical significance of glucocorticoid ingestion at any stage between the SLE-ONF group and DM/PM group. Multiple factor logistic regression analysis revealed that  high level of AnuA, positive anti-SSB antibodies, knee pain,   sudden stop of  glucocorticoid, and the initial dose of prednisolone over 60mg/d, were associated with ONF(P<0.05). Conclusion    Both glucocorticoid and SLE disease itself are important factors for the development of ONF.

Key words: Lupus erythematosus; systemic; Femoral head; osteonecrosis; Logistic regression analysis