MODIFIABLE RISK FACTORS FOR ADVERSE OUTCOMES IN SLE

这项研究的目的是前瞻性地确认先前研究的系统性红斑狼疮(SLE)不良结局的危险因素。可修改的风险因素已被证明对SLE的疾病活动性和SF 36评估的健康状况都有影响。我们的目标是确认潜在的可改变的风险因素，如自我效能和社会支持确实影响疾病活动(SLAM)和健康状况(SF36)。心血管疾病导致系统性红斑狼疮年轻女性的过度发病率和死亡率。我们计划研究系统性红斑狼疮患者心血管危险因素管理(危险因素检测和管理的适当性)的变化。我们还计划研究心血管风险因素管理、SLE特有因素、社会人口和心理社会因素之间的关系，以及：a)中间结果，包括吸烟、高血压、高脂血症、久坐不动的生活方式、肥胖和糖尿病；以及b)心血管事件，包括心绞痛、心肌梗死、充血性心力衰竭和中风。这项拟议研究的基本设计是对40名患者进行前瞻性随访，这些患者在1989至1994年间首次接受评估。每个患者都将被要求通过邮寄的方式填写一份问卷。在此之后，受试者将来诊所接受医生对疾病活动的评估(SLAM)。疾病活跃度将在6个月后使用SA-SLAM进行测量，身心健康将由SF36进行测量。此表将通过邮寄、电话或家访跟进的方式填写，无回应者。受试者将被要求公布所有提供者和医院自诊断为狼疮以来关于他们护理的所有医疗记录，并在诊断之前公布相关问题。这些记录将被审查是否有心血管危险因素。

The objective of this investigation is to prospectively confirm previously examined risk factors for adverse outcomes in Systemic Lupus Erythematosus (SLE). Modifiable risk factors have been shown to impact on both the disease activity, as measured by the SLAM as well as health status assessed by SF 36 in SLE. We aim to confirm that potentially modifiable risk factors such as self-efficacy and social support do effect disease activity (SLAM) and health status (SF36). Cardiovascular disease results in excess morbidity and mortality in young women with SLE. We plan to study the variation in cardiovascular risk factor management (risk factor detection and appropriateness of management according to published guidelines) in patients with SLE. We also plan to look at the association between cardiovascular risk factor management, SLE-specific factors, socio-demographic and psychosocial factors and : a) intermediate outcomes including smoking, hypertension, hyperlipidemia, sedentary lifestyle, obesity and diabetes; and b) cardiovascular events including angina, myocardial infarction, congestive heart failure and stroke. The basic design of the proposed study is a prospective follow-up of 40 patients who were first evaluated between 1989 and 1994. Each patient will be asked to fill out a questionnaire by mail. After this subjects will come to the clinic for a physician assessment of disease activity (SLAM). Disease activity will be measured 6 months later using the SA-SLAM and physical and mental health will be measured by the SF36. This will be filled out by mail with telephone or home visit follow-up for non-respondents. Subjects will be asked to release all medical records regarding their care from all providers and hospitals since their diagnosis of lupus, and for relevant problems prior to diagnosis. The records will be reviewed for cardiovascular risk factors.