四川汶川大地震对系统性红斑狼疮患者病情活动的影响

Influence of the Sichuan Wenchuan Earthquake on Disease Activity in Patients with Systemic Lupus Erythematosus

目的:探讨5.12四川汶川大地震对系统性红斑狼疮(SLE)病情活动性的影响,以及因地震造成的停药、感染、居住环境恶劣(长期紫外线照射)和创伤后应激障碍(posttraumatic stress disease,PTSD)与病情活动性的相关性。方法:分析41例重灾区(北川、平武、江油、安县)SLE患者地震前后实验室指标和临床表现变化情况,采用Logistic回归分析地震造成停药、感染、居住环境恶劣和PTSD四种因素对SLE病情活动性的影响。结果:41例SLE患者地震后有18例病情活动,其中有27%患者出现关节痛,24%出现颜面红斑,19.5%出现发热,22%合并狼疮肾炎,震后C3水平显著低于震前。震后6例患者感染,13例患者停药,16例患者长期居住于恶劣环境中,11例患者患PTSD。通过Logistic回归分析发现PTSD、停药、居住条件恶劣与地震后SLE患者病情活动相关。结论:地震可使一部分重灾区SLE患者病情出现活动,PTSD、停药、居住条件恶劣与SLE病情活动具有相关性。

Objective：To investigate the impact of the massive earthquake on the disease activity in patients with systemic lupus erythematosus（SLE）,and to evaluate the disease activity associated with the possible triggering factor after earthquake,including infection,posttraumatic stress disorder（PTSD）,discontinuation（3 months after the earthquake） and sun exposure.Methods：Forty-one SLE living in the earthquake regions were enrolled,all patients underwent a clinical and laboratory evaluation,together with the possible triggering factor that led to disease activity.In addition,posttraumatic stress disorder was measured in these subjects who were living in transient house three months after earthquake.Results：The major symptoms for lupus patient after the earthquake include arthralgia（24%）,malarrash（24%）,fever（19.5%）,lupus nephritis（22%）.A significant decrease of serum C3 was noticed after the earthquake.The disease activity of 43.9% patients was active（SLEDAI≥8）.Among them,12.2% were infected,26.8% developed PTSD,26.8% discontined,22% were exposured scolar radiation.Longitudinal analyses showed that disease activity was associated with PTSD,discontinuation and sun exposure.Conclusion：A small number of our patients have disease activity after earthquake.PTSD,discontinuation and sun exposure are correlated with the disease activity of systemic lupus erythematosus.