Bellomio V, Spindler A, Lucero E, Berman A, Santana M, Moreno C, Hidalgo R P, Paira S, Graf C, Maldonado Cocco J A, Citera G, Arriola M S, Gómez G, Barreira J C, Messina O, Asnal C, Carrillo D, Gervilla A, García L, Máscolo M, De la Sota M D, Rosso G, Somma L F, Sosa R F, Rillo O, Caracciolo J A, Lancioni G, Gómez A
Posgrado de Reumatología, Universidad Nacional de Tucumán, Argentina.
Lupus. 2000;9(5):377-81.
To analyze the factors associated with mortality, survival and causes of death in patients with systemic lupus erythematosus (SLE) in Argentina.
A series of 366 patients with SLE (45 men and 321 women), mean age 29 y (range 11-70 y) and mean disease duration 6 y, was evaluated from 1990 to 1998. A total of 57 clinical, serological and therapeutic variables were studied.
Five- and 10-year survival was 91% and 85% respectively. Forty four patients died (12%): 54% due to sepsis and 32% due to active SLE. Mortality risk factors included heart involvement CRR 3.82), hyperlipidemia (RR 2.72), renal damage (RR 2. 62), infections (RR 2.44), lung disease (RR 2.20) and myositis (RR 2. 07). High-dose prednisone (RR 3.4) or cyclophosphamide (RR 9.19) treatments increased the risk of sepsis (P=0.003) as a cause of death. However, corticosteroids, antimalarial agents and accumulated cyclophosphamide doses proved to be protective factors in overall mortality figures (RR <1).
The main risk factors of death in SLE were heart involvement, hyperlipidemia and renal damage. Treatment with steroids, antimalarial agents and cyclophosphamide improved survival. High-dose corticosteroids and cyclophosphamide were associated with sepsis as a cause of death.
分析阿根廷系统性红斑狼疮（SLE）患者的死亡、生存相关因素及死因。
对1990年至1998年间评估的366例SLE患者（45例男性和321例女性）进行研究，平均年龄29岁（范围11 - 70岁），平均病程6年。共研究了57项临床、血清学和治疗变量。
5年和10年生存率分别为91%和85%。44例患者死亡（12%）：54%死于败血症，32%死于活动性SLE。死亡风险因素包括心脏受累（相对危险度[RR] 3.82）、高脂血症（RR 2.72）、肾损害（RR 2.62）、感染（RR 2.44）、肺部疾病（RR 2.20）和肌炎（RR 2.07）。高剂量泼尼松（RR 3.4）或环磷酰胺（RR 9.19）治疗增加了败血症作为死亡原因的风险（P = 0.003）。然而，皮质类固醇、抗疟药和累积环磷酰胺剂量在总体死亡率数据中被证明是保护因素（RR <1）。
SLE患者死亡的主要风险因素是心脏受累、高脂血症和肾损害。使用类固醇、抗疟药和环磷酰胺治疗可提高生存率。高剂量皮质类固醇和环磷酰胺与败血症作为死亡原因相关。
