Health-related quality of life in patients with systemic lupus erythematosus and proliferative lupus nephritis
Health-related quality of life in patients with systemic lupus erythematosus and proliferative lupus nephritis
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DOI：
10.1080/13548506.2011.554566
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发表时间：
2011-01-01
影响因子：
3.8
通讯作者：
Kaptein, Ad A.
中科院分区：
文献类型：
--
作者：
Daleboudt, Gabrielle M. N.;Berger, Stefan P.;Kaptein, Ad A.
本研究调查了两种不同的肾脏炎症（即增殖性狼疮性肾炎）治疗方法对慢性自身免疫性疾病系统性红斑狼疮 (SLE) 患者健康相关生活质量 (HRQoL) 的影响。其中一种治疗方案，即美国国立卫生研究院 (NIH) 方案，其特点是使用高剂量的环磷酰胺（CYC，一种免疫抑制药物），而第二种治疗方案，即欧洲狼疮方案，则涉及低剂量的 CYC。根据 Euro-Lupus 或 NIH 方案，根据增生性狼疮性肾炎发作所接受的治疗，纳入了 32 名 SLE 患者。通过 SF-36 和 SLE 症状检查表 (SSC) 测量两组的 HRQoL 进行比较。在 SF-36 的七个量表中的四个上，欧洲狼疮组 (N = 16) 往往表现出比 NIH 组 (N = 16) 更高的 HRQoL。此外，根据 SSC 的评估，欧洲狼疮组的恶心或呕吐负担比 NIH 组要少。疲劳是两组中最令人不安的症状。治疗中最繁重的方面与化疗（55.2%）和泼尼松的使用（34.5%）有关。 HRQoL 低且疲劳程度高的患者血清补体 C4 水平更可能较低（即免疫活性升高）。总之，根据 EuroLupus 方案治疗的患者可能比接受 NIH 治疗的患者经历更高的 HRQoL。然而，低剂量治疗方案中的化疗仍然是负担。讨论了进一步提高患有增殖性狼疮肾炎的 SLE 患者 HRQoL 的潜在干预措施。
This study investigated the influence of two different treatments for a kidney inflammation (i. e. proliferative lupus nephritis) on health-related quality of life (HRQoL) in patients with the chronic auto-immune disease systemic lupus erythematosus (SLE). One treatment protocol, the National Institutes of Health (NIH) protocol, was characterized by a high dose of cyclophosphamide (CYC, an immunosuppressive drug), and the second treatment, the Euro-Lupus protocol, involved a low-dose CYC. Thirty-two SLE patients were included based on the received treatment for an episode of proliferative lupus nephritis, according to either the Euro-Lupus or the NIH protocol. The two groups were compared on HRQoL as measured by the SF-36 and the SLE Symptom Checklist (SSC). The Euro-Lupus group (N = 16) tended to show a higher HRQoL than the NIH group (N = 16) on four of seven scales of the SF-36. In addition, the Euro-Lupus group experienced less burden from nausea or vomiting than the NIH group as assessed by the SSC. Fatigue was the most disturbing symptom in both groups. The most burdensome aspects of treatment were related to chemotherapy (55.2%) and use of prednisone (34.5%). Patients with a low HRQoL and high levels of fatigue were more likely to have low levels of serum complement C4 (i. e. elevated immune activity). In conclusion, patients who are treated according to the EuroLupus protocol may experience a higher HRQoL than patients who receive the NIH treatment. However, chemotherapy remains burdensome in the low-dose treatment regimen. Potential interventions to further enhance the HRQoL in SLE patients with proliferative lupus nephritis are discussed.