论文部分内容阅读
目的研究系统性红斑狼疮(SLE)患者的预后和影响预后的危险因素。方法对1980—1990年就诊于上海第二医科大学仁济医院风湿病科50例SLE患者的临床资料进行回顾性分析。结果以确诊时间计算,其1年、5年、10年存活率分别为98%、86%、76%。12例缓解,其平均缓解时间为4年。38例存活,28例正常工作和生活;发病时未婚女青年24例,发病后21例已婚,16例正常生育。12例死亡,主要死亡原因为肾功能衰竭(33.3%)和感染(33.3%)。影响预后的因素多脏器受累,弥漫性血管炎,持续性低补体血症,严重贫血,血肌酐升高,重度蛋白尿。血小板减少对预后无不良影响。未发现中枢性狼疮对预后的严重影响。伴发雷诺现象(RP)14例,其中5例死亡,9例存活中6例RP消失,表明RP可以逐渐消失,对预后无不良影响。结论早期诊断和治疗,防治激素治疗的副反应,控制感染和肾功能衰竭有助于改善SLE患者的预后,提高存活率。
Objective To study the prognosis and risk factors of prognosis in patients with systemic lupus erythematosus (SLE). Methods The clinical data of 50 SLE patients attending Department of Rheumatology, Renji Hospital, Shanghai Second Medical University from 1980 to 1990 were analyzed retrospectively. The results of the diagnosis of time, the 1-year, 5-year, 10-year survival rates were 98%, 86%, 76%. 12 cases were relieved, and the average remission time was 4 years. 38 cases survived, 28 cases of normal work and life; the incidence of unmarried young women in 24 cases, 21 cases were married, 16 cases of normal fertility. 12 died, the main cause of death was renal failure (33.3%) and infection (33.3%). Factors affecting the prognosis of multiple organ involvement, diffuse vasculitis, persistent hypocomplementemia, severe anemia, serum creatinine, severe proteinuria. Thrombocytopenia has no adverse effect on the prognosis. No significant effect of central lupus on prognosis was found. There were 14 cases accompanied with RENAULT phenomenon (RP), of which 5 cases died and 6 cases RP disappeared in 9 cases, indicating that RP can disappear without any adverse effect on prognosis. Conclusion Early diagnosis and treatment, prevention and treatment of side effects of hormone therapy, infection control and renal failure help to improve the prognosis of patients with SLE and improve the survival rate.