Analysis of the relationship between disease activity and damage in patients with systemic lupus erythematosus - a 5-yr prospective study
Analysis of the relationship between disease activity and damage in patients with systemic lupus erythematosus - a 5-yr prospective study
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DOI：
10.1093/rheumatology/keh238
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发表时间：
2004-08-01
期刊：
影响因子：
5.5
通讯作者：
Isenberg, DA
中科院分区：
文献类型：
--
作者：
Stoll, T;Sutcliffe, N;Isenberg, DA
Objective.为了确定是否初始损害，疾病持续时间，年龄，初始健康状况，平均疾病活动超过5年或平均药物治疗评分涵盖随访期间将预测系统性红斑狼疮（SLE）患者在未来5年内损害的增加。一项为期5年的前瞻性纵向研究，对141例连续SLE患者进行队列研究，这些患者在伦敦的狼疮专科门诊就诊，自1994年7月至1995年2月首次评估。使用BILAG系统评估疾病活动性，通过医学结局调查简表20评估初始健康状态，并通过SLICC/ACR损伤指数（SDI）评估疲劳（SF-20+）和损伤。5年后重新评估了损害。采用多元逻辑回归分析（logXact）进行统计学分析。纳入133名女性和8名男性SLE患者（97名白人，16名非洲-加勒比人，22名亚洲人和6名其他人），入选时年龄为41.1 ± 12.5岁，病程为10.2 ± 6.3年。入选时的平均测量值为：总BILAG 5.2（范围0-17），总SDI 1.2（0-7）和药物评分1.2（0-3）。6名患者因搬家而失访。在其余135名患者中，40名患者的总损伤增加，10名患者死亡。在研究结束时，4.63 +/- 0.19岁时，总SDI增加到1.6 +/- 1.7。多因素Logistic回归分析显示，在整个研究期间，高的疾病活动度强烈预测死亡和损害的增加（P
Objective. To determine whether initial damage, disease duration, age, initial health status, average disease activity over the 5 yr or an average medication score covering the follow-up period would predict an increase in damage in patients with systemic lupus erythematosus (SLE) within the next 5 yr.Methods. A 5-yr prospective longitudinal study of a cohort of 141 consecutive patients with SLE attending a specialist lupus out-patient clinic in London from their first assessment between July 1994 and February 1995. Disease activity was assessed using the BILAG system, initial health status by the Medical Outcome Survey Short Form 20 with an extra question about fatigue (SF-20+) and damage by the SLICC/ACR Damage Index (SDI). Damage was reassessed 5 yr later. Statistical analysis was carried out using multiple logistic regression analysis (logXact).Results. One hundred and thirty-three female and eight male SLE patients (97 Caucasians, 16 Afro-Caribbeans, 22 Asians and 6 others) were included, their age at inclusion was 41.1 +/- 12.5 yr and their disease duration 10.2 +/- 6.3 yr. The mean measures at inclusion were: total BILAG 5.2 (range 0-17), total SDI 1.2 (0-7) and medication score 1.2 (0-3). Six patients were lost to follow-up because they had moved. Of the remaining 135 patients total damage had increased in 40 patients and 10 patients had died. At the end of the study, at 4.63 +/- 0.19 yr, the total SDI had increased to 1.6 +/- 1.7. Multiple logistic regression analysis revealed that death and increase in damage were strongly predicted by a high total disease activity over the entire study period (P