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目的 通过对系统性红斑狼疮 (SLE)患者的死因分析 ,提高对致死原因的认识 ,为合理治疗、降低其病死率提供科学依据。方法 对 1988～ 2 0 0 0年收治的 486例SLE患者进行回顾性调查 ,分析计算病死率及死亡病因分布情况。结果 486例患者中死亡 88例 ,病死率 18 11%。死因依次为 :SLE 3 9例 (4 4 3 2 % ) ;感染 2 8例 (3 1 82 % ) ;心血管疾病 13例(14 77% ) ;脑血管疾病 6例 (6 82 % ) ;癌症 2例 (2 2 7% )。病程分布 ,死亡患者 3年内死亡率高。结论 系统性红斑狼疮引起的多器官或单器官功能损害是最主要死亡原因 ,感染次之 ,心血管疾病居第 3位。SLE患者于确诊后 3年内 (病程 <3年 )的病死率明显增高 (与 3年后比较P <0 0 1) ,故对活动性SLE应积极治疗 ,但不能过度 ,以免因机体抵抗力过低诱发感染而死亡。尤其应重视并加强 3年内病人的治疗
Objective To analyze the cause of death in patients with systemic lupus erythematosus (SLE) and to improve the understanding of the cause of death, so as to provide a scientific basis for rational treatment and reduction of mortality. Methods A retrospective investigation was performed on 486 SLE patients admitted between 1988 and 2000, and the distribution of death and the cause of death were analyzed and calculated. Results 486 patients died of 88 cases, the mortality rate was 18 11%. The causes of death were as follows: 9 cases of SLE (44.3%); 28 cases of infection (31.82%); 13 cases of cardiovascular disease (14.7%); 6 cases of cerebrovascular disease 2 cases (2 2 7%). The course of the disease, the death of patients with high mortality within 3 years. Conclusions The main cause of death of multiple organ or single organ dysfunction caused by systemic lupus erythematosus is the second leading cause of death and the third leading cause of cardiovascular disease. SLE patients within 3 years after diagnosis (duration <3 years) mortality was significantly increased (compared with 3 years after P <0 01), active SLE should be active treatment, but not excessive, so as to avoid the body resistance over Low-induced infection and death. In particular, attention should be paid to strengthening the treatment of patients within 3 years