系统性红斑狼疮20年生存率及预后因素分析

Analysis of 20-year survival rate and prognostic indicators of systemic lupus erythematosus

目的分析系统性红斑狼疮(SLE)患者20年生存率、死亡原因和影响预后的因素。方法回顾性收集2008年6月前于北京大学人民医院初诊的217例SLE患者及其病程中的临床及血清学资料进行了随访,分析生存率、生存现况、死亡原因及预后相关因素。结果从诊断时计算SLE患者10、15、20年的累积生存率分别为90.3%、88.1%和79.6%。感染和狼疮脑病是最常见的死亡原因。多因素分析显示初诊时狼疮肾损害、神经精神狼疮、发病年龄是死亡的独立危险因素。结论系统性红斑狼疮的预后仍较差,早期诊断、控制脏器损害以及预防感染,对提高患者生存率有重要意义。

Objective To analyze the 20-year survival rate, causes of death and predictors of systemic lupus erythematosus (SLE). Methods A retrospective analysis was performed on 217 newly SLE patients who were diagnosed and treated by Peking University People′s Hospital before June 2008. The clinical features and serologic data were studied. Survival rate of SLE patients over time, living conditions, causes of death and prognostic indicators of mortality were studied. Results The 10-, 15-and 20-year cumulative survival rate was 90.3%,88.1%and 79.6%, respectively. Infection and lupus encephalopathy were the main causes of death. Cox regression analysis revealed that lupus nephritis, neuropsychiatric systemic lupus erythematosus and age at the diagnosis were independent risk determinants for mortality. Conclusion Prognosis of SLE remains to be improved. Early diagnosis, control of SLE organ damage and infection prevention are critical to improve survival of SLE patients.