联合抗疟药治疗红斑狼疮对其生存率的影响

Antimalarials Improve the Survival of Patients with Systemic Lupus Erythematosus

目的:分析抗疟药[羟氯喹(HCQ)与氯喹(CQ)]对系统性红斑狼疮(SLE)患者生存率的影响,为SLE患者治疗方案提供依据。方法:随访自1999年1月1日至2009年12月31日首次在我院住院的SLE患者,分为使用抗疟药组和未使用抗疟药组。记录患者的年龄、性别、病程、随访时间、生存状态、病情活动度、脏器损害、系统受累、自身抗体以及用药情况,对两组生存率进行比较。结果:使用抗疟药组共106例,其中皮肤黏膜受累者占67.9%,而未使用抗疟药组共94例,其中皮肤黏膜受累者占41.5%(P=0.00)。使用组和未使用组的1、3、5、10、15年生存率分别为97.1%、93.3%、93.3%、91.9%、91.9%和90.4%、85.1%、80.9%、77.4%、74.1%;两组生存率有统计学差异(P=0.01)。结论:抗疟药对SLE患者有保护作用,改善长期预后,可以提高生存率。

Objective: To analyze the effect of antimalarials (including hydroxychloroquine, HCQ and chloroquine, CQ) on the survival of patients with systemic lupus erythematosus (SLE) as evidence for treatment. Methods: Follow-ups were done on inpatients with SLE from January 1, 1999 to December 31, 2009 in the Department of Rheumatology and Immunology of our hospital for the first time. They were divided into two groups: those who used antimalarials and those who did not use antimalarials. Age, sex, course of disease, follow-up time, survival status, disease activity, organ damages, systemic involvements, autoantibodies and medication were recorded. Survival rates of the two groups were analyzed and compared. Results: There were 106 patients using antimalarial drugs, of which 67.9% were affected in skin and mucosa, while for the 94 patients without antimalarial drugs, 41.5% were affected in skin and mucosa (P=0.00). The 1, 3, 5, 10 and 15-year survival rates for the patients using antimalarials vs those without antimalarials were 97.1%, 93.3%, 93.3%, 91.9% and 91.9% vs. 90.4%, 85.1%, 80.9%, 77.4% and 74.1%, respectively (P=0.01). Conclusions: Antimalarial drugs have protective effects on SLE patients in China. They can improve the survival rate and long-term prognosis of SLE patients.