系统性红斑狼疮155例临床及预后分析

Clinical and prognosis analysis of 155 patients with systemic lupus erythematosus

目的观察SLE患者临床经过与预后的关系。方法对155例确诊SLE患者的临床治疗经过进行回顾性分析和病例追踪随访,并应用生命表法对其生存率进行统计学分析。结果收治的155例SLE患者,其中134例为女性,21例男性。155例中2例(1.6%)发生急性狼疮性肺炎。5例(3.2%)发生狼疮性脑病。接受激素治疗≥5年的80例SLE病中6例(7.5%)发生无菌性股骨头坏死。44例临床出现肾功能异常者进行了肾活检病理检查,其中38例符合狼疮性肾炎的病理改变。死亡6例(住院5例、院外1例)均为女性。155例中结核感染患病率为18.0%(28/155),病死率为10.7%(3/28)。本组5年、10年、15年和20年生存率分别为78.3%,63.1%,32.14%,20.8%。结论本组男女比1∶6.4,提示雌性激素可能促使SLE发病。而5年、10年、15年和20年生存率分别为78.3%,63.1%,32.14%和20.8%,比文献报道略低,可能与本组病人病情较重,合并结核病比例高有一定关系,另外可能与病例丢失较多有关。

Objective To investigate the relationship of clinical course and prognosis in 155 patients with systemic lupus erythematosus（SLE）. Methods The clinical features and treatment of 155 SLE patients were retrospectively analyzed and followed up, and survival rate was examined statistically using life graph. Results In 155 SLE patients, 134 were female, 21 were male. Two patients（1.6% ） suffered from acute, pneumonitis. Five patients （3.2%） suffered from neuropsychiatic SLE. Six in 80 patients （7.5%） were given steroid resulting in asepsis thighbone putrescence,44 patients with impaired renal function by renal biopsy, and 38 patients were in accordance with SLE nephritis. Six patients were dead. In 155 SLE patients, 18.0% suffered from tuberculosis and case motality rate was 10.7%. The survival rate of 5 years, 10 years, 15 years and 20 years were 78.3% ,63.1% ,32.14% and 20.8%, respectively. Condusion The cause of SLE is unclear. In this study female patients with SLE are far more than male patients, showing estrogen might one of the causes of SLE. That survival rates were lower than previous reports may be associated with serious situation and combined with tuberculosis.