系统性红斑狼疮五年生存率及影响预后的因素

Analysis of 5-year survival rate and prognostic indicators of systemic lupus erythematosus

目的探讨系统性红斑狼疮患者的5年生存率、死亡原因及影响预后的因素。方法回顾性收集2013年1月-2015年12月就诊于新疆维吾尔自治区人民医院风湿免疫科初治的202例系统性红斑狼疮患者的临床资料及实验室检查结果并进行随访,分析生存率、死亡原因及预后相关因素。结果从确诊时计算SLE的5年生存率为97%,感染是最常见的死亡原因。单因素分析显示诊断时SLE肾损害、多系统损害对预后有影响,多因素回归分析发现初诊时SLE肾损害、狼疮脑病是死亡的独立危险因素,而性别、发病年龄、病程、血液系统损害、浆膜腔损害、抗dsDNA抗体阳性及低补体对预后无统计学意义。结论早期诊断及控制SLE脏器损害,同时预防感染,是提高患者生存率的关键。

Objective To investigate the 5-year survival rate,causes of death and prognostic factors in patients with systemic lupus erythematosus(SLE).Methods The clinical data and laboratory examination results of 202 patients with systemic lupus erythematosus,who were treated atthe department of Rheumatology and Immunology ofpeople’s hospital of Xinjiang Uygur Autonomous region from January2013 to December 2015,were collected and followed up.Survival rate,reasonof death and prognostic factors were analyzed.Results The 5-year survival rate of SLE was 97%at the time of diagnosis,and infection was a common reasonfor death.Univariate analysis showed that SLE renal damage and multiple system involvement had significant effects on prognosis.Further multivariate regression analysis showed that SLE renal damage and lupus encephalopathy were independent risk factors for death,while sex,age,course of disease,blood system damage,serous cavity damage,positive anti-dsDNA antibody and low complement had no significant effect on prognosis.Conclusions Early diagnosis,control of SLE organ damage and prevention of infection are the key to improve the survival rate of patients.