55例系统性红斑狼疮患者死亡原因分析

Analysis of Death Causes on 55 Dead Cases with Systemic Lupus Erythematosus

目的:了解近年来住院系统性红斑狼疮(SLE)患者的主要死亡原因,提高对系统性红斑狼疮病死原因的认识,从而指导临床治疗工作,降低病死率。方法:采用SPSS13.0统计软件对2002年1月～2010年4月哈尔滨医科大学附属第二医院住院治疗并无效死亡的系统性红斑狼疮患者进行回顾性分析。结果:住院患者333例,死亡55例,其中男性4例,女性51例,男女之比为1:12.75;55例死亡患者中,50例为SLE引起的多个脏器损害,占90.91%;受累脏器以肾脏最多见,为45例,衰竭脏器以心脏最多见,其次是肾脏和呼吸系统功能衰竭;SLEDAI评分最低为5分,最高为44分,均为SLE病情活动,并有45例为SLE重度活动,占81.82%。结论:本组病例中,SLE发病第1年内死亡的比例最高,占41.82%。以SLE导致多器官功能障碍为主要死因。早期诊断,及早保护重要脏器功能,控制狼疮活动,预防感染,确保治疗的依从性,是改善SLE预后,提高生存率的关键。

Objective：To investigate the main cause of death in patients with systemic lupus erythematosus（SLE） in recent years,so as to improve the understanding of the causes of death,guide clinical treatment and reduce the mortality.Methods：Retrospectively analyzed the dead SLE cases after treatment in The 2nd Affiliated Hospital of Harbin Medical University from January 2002 to April 2010 by the statistical software SPSS13.0.Results：There were 55 dead cases in 333 hospitalized patients with SLE,including four male patients,51 cases of women,this ratio for 1：12.75.In these 55 cases,50 cases for the multiple organs damage,accounted for 90.91%.Kidney damage most commonly,had 45 cases.The heart failure was the most common,followed by kidney failure and respiratoryfailure.SLEDAI score from 5 to 44 points,all were in SLE activity,and 45 patients with stage of SLE severe activities,accounted for 81.82%.Conclusions：In all the cases,the death rate in the first year of SLE was the highest,accounted for 41.82%.Multiple organ dysfunction is the main cause of death in SLE.The early diagnosis and protection of important viscera function,controlling lupus activity,preventing infection and ensuring compliance of treatment might be the key to improve the prognosis and improve survival rates.