Prospective Study of Neuropsychiatric Events in Systemic Lupus Erythematosus
Prospective Study of Neuropsychiatric Events in Systemic Lupus Erythematosus
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DOI：
10.3899/jrheum.081133
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发表时间：
2009-07-01
影响因子：
3.9
通讯作者：
Thompson, Kara
中科院分区：
文献类型：
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作者：
Hanly, John G.;Su, Li;Thompson, Kara
Objective.前瞻性研究系统性红斑狼疮（SLE）患者神经精神（NP）事件及其与健康相关生活质量（HRQOL）的关系。在来自其单一学术中心的观察性队列研究中。在入组时和LIP至7年的年度评估时确定NP事件及其归因。NP事件的特征采用美国流变学学会病例定义：其他变量为全身SLE疾病活动和累积器官损伤。记录NP事件的结局，并采用医学结局研究简表-36中的精神（MCS）和身体（PCS）部分总结评分测量自我报告HRQOL。共有209例患者，88%为女性，92%为白人，平均（标准差）年龄为43.7（13.8）岁。175/209例（84%）患者获得随访。在平均3.6（2.5）年的随访期间，132/209（63%）例患者发生了299起NP事件。54例患者中31%的NP事件归因于SLE。多变量分析表明，无论归因如何，发生NP事件的患者的MCS评分均低于未发生NP事件的患者（p < 0.001）。无论归因如何，发生NP事件的患者的PCS评分组平均值显著较低（p < 0.001）。HRQOL与累积器官损害之间无相关性，NP事件与器官损害进展之间也无相关性。随着时间的推移，较低的HRQOL与NP事件的相关性，这与累积器官损伤的进展无关，强调了NP事件对SLE患者生活的持续负面影响。（2009年5月15日首次发布：J Rheumol 2009：36：1449-59：doi：10.3899/jrheum.081133）
Objective. To prospectively examine neuropsychiatric (NP) events and their association with health related quality of life (HRQOL) over time in patients with systemic lupus erythematosus (SLE).Methods. In in observational cohort study from it single academic center. NP events and their attribution were identified at enrollment and at annual assessments for LIP to 7 years. NP events were characterized using the American College of Rheumatology case definitions: other variables were global SLE disease activity and cumulative organ damage. The outcomes of NP events were recorded and self-report HRQOL was measured with the mental (MCS) and physical (PCS) component summary scores of the Medical Outcomes Study Short Form-36.Results. There were 209 patients, 88% female and 92% Caucasian, with it mean (standard deviation) age of 43.7 (13.8) years. Followup was available in 175/209 (84%) patients. There were 299 NP events in 132/209 (63%) patients over a mean followup of 3.6 (2.5) years. Thirty-one percent of NP events in 54 patients were attributed to SLE. Multivariate analysis indicated lower MCS scores in patients with NP events compared to those without events (p < 0.001) regardless of attribution. The group means for PCS scores were significantly lower in patients with NP events (p < 0.001) regardless of attribution. There was no association between HRQOL and Cumulative organ damage, nor between NP events and the progression of organ damage.Conclusion. The association of lower HRQOL with NP events over time, which is independent of progression in cumulative organ damage, emphasizes the persistent negative effect of NP events in the lives of patients with SLE. (First Release May 15 2009: J Rheumatol 2009:36:1449-59: doi: 10.3899/jrheum.081133)