A prospective study of survival and prognostic indicators of systemic lupus erythematosus in a southern Chinese population
A prospective study of survival and prognostic indicators of systemic lupus erythematosus in a southern Chinese population
复制标题
DOI：
10.1093/rheumatology/39.4.399
复制
发表时间：
2000-04-01
期刊：
影响因子：
5.5
通讯作者：
Wong, RWS
中科院分区：
文献类型：
--
作者：
Mok, CC;Lee, KW;Wong, RWS
目标。研究中国南方人群系统性红斑狼疮（SLE）的生存率和预后指标。方法。对 1992 年至 1999 年间诊断的 186 名 SLE 患者进行了前瞻性随访。获得了就诊时的临床特征、随后的演变特征、自身抗体谱、损伤评分和死亡率数据。通过统计分析研究生存的预后因素。结果。对 163 名女性 SLE 患者和 23 名男性 SLE 患者进行了研究。女性与男性的比例为 7.1 比 1，就诊时的平均年龄为 33.6 岁（范围 12-75 岁）。平均病程为 45.2 个月。诊断时，关节炎、颧骨皮疹和脱发是最常见的特征。随访期间，肾炎、关节炎、光敏性和血液病的患病率明显增加。在数据分析时，31％的患者存在器官损伤，而肾脏疾病是最常见的原因。 Logistic回归显示中枢神经系统疾病、盘状病变和大剂量类固醇治疗是损伤的独立预测因素。九名患者在研究期间死亡（三名患者死于疾病相关并发症，六名患者死于感染）。我们队列的 3 年、5 年和 7 年生存率分别为 97%、93% 和 93%。 Cox回归分析显示血小板减少和大剂量类固醇治疗是死亡的独立危险因素。结论。中国南方患者的 SLE 生存率与 20 世纪 90 年代报道的白种人系列相似。尽管肾炎会导致器官损伤，但它并不是生存的主要决定因素。感染仍然是最常见的死亡原因。大剂量类固醇治疗和血小板减少症是死亡的独立危险因素。明智地使用免疫抑制剂对于提高 SLE 的短期生存率是必要的。
Objectives. To study the survival rate and prognostic indicators of systemic lupus erythematosus (SLE) in a southern Chinese population.Methods. One hundred and eighty-six patients with SLE diagnosed between 1992 and 1999 were prospectively followed. Clinical features at presentation, subsequent evolving features, autoantibody profile, damage scores and mortality data were obtained. Prognostic factors for survival were studied by statistical analysis.Results. One hundred and sixty-three female and 23 male SLE patients were studied. The female to male ratio was 7.1 to 1 and the mean age at presentation was 33.6 yr (range 12-75). The mean disease duration was 45.2 months. At diagnosis, arthritis, malar rash and alopecia were the commonest features. During follow-up, the prevalence of nephritis, arthritis, photosensitivity and haematological disease increased significantly. Thirty-one per cent of the patients had organ damage at the time of data analysis and renal disease was the commonest cause. Logistic regression revealed that central nervous system disease, discoid lesions and treatment with high-dose steroid were independent predictors for damage. Nine patients died during the study period (three of disease-related complications and six of infections). The 3-, 5-, and 7-yr survival rates of our cohort were 97, 93 and 93%, respectively. Cox regression analysis revealed that thrombocytopenia and high-dose steroid treatment were independent risk factors for mortality.Conclusions. The survival of SLE in our southern Chinese patients is similar to that of the Caucasian series reported in the 1990s. Although nephritis contributes to organ damage, it is not a major determinant for survival. Infection remains the commonest cause of death. High-dose steroid treatment and thrombocytopenia are independent risk factors for mortality. Judicious use of immunosuppressive agents is necessary to improve the short-term survival of SLE.