Gilboe I M, Kvien T K, Husby G
Oslo City Department of Rheumatology, Diakonhjemmet Hospital, and the Centre for Rheumatic Diseases, The National Hospital, Oslo, Norway.
J Rheumatol. 2001 Feb;28(2):266-74.
To examine changes in health status, disease activity, and organ damage after 2 years and to study possible disease variables predicting change in health status, disease activity, and organ damage at followup in systemic lupus erythematosus (SLE). Second, to compare changes in health status in patients with SLE to that of matched patients with rheumatoid arthritis (RA) and matched healthy controls.
A 2 year longitudinal observational study, measuring health status (Short-Form 36. visual analog scale for pain and fatigue, modified Health Assessment Questionnaire, patient global assessment of disease activity), disease activity, and organ damage in 87 patients with SLE. Health status measures in SLE were compared to 65 matched RA patients selected from the Oslo RA register and to 77 matched healthy controls from the population register.
On a group level the SLE patients showed stable health status measures and disease activity scores 2 years after baseline, but organ damage scores increased significantly. Increase in organ damage was significantly and independently predicted by baseline scores of disease activity and organ damage, health status, and disease activity by the respective baseline scores. Changes in health status measures over 2 years were similar in SLE, RA, and healthy controls.
Our 2 year longitudinal observational SLE study showed a stable course of health status and disease activity, whereas organ damage increased. Disease activity and organ damage at baseline predicted the latter. Our results indicate the value of careful monitoring of disease activity over time in SLE and individually tailored treatment guided by the predictors of course and outcome.
研究系统性红斑狼疮（SLE）患者在2年后健康状况、疾病活动度及器官损害的变化，并探讨随访时可能预测健康状况、疾病活动度及器官损害变化的疾病变量。其次，比较SLE患者与匹配的类风湿关节炎（RA）患者及匹配的健康对照者健康状况的变化。
一项为期2年的纵向观察性研究，对87例SLE患者的健康状况（简短健康调查问卷36项、疼痛和疲劳视觉模拟量表、改良健康评估问卷、患者对疾病活动度的整体评估）、疾病活动度及器官损害进行测量。将SLE患者的健康状况测量结果与从奥斯陆RA登记册中选取的65例匹配的RA患者以及从人口登记册中选取的77例匹配的健康对照者进行比较。
在组水平上，SLE患者在基线后2年健康状况测量结果和疾病活动度评分保持稳定，但器官损害评分显著增加。疾病活动度和器官损害的基线评分、健康状况以及疾病活动度的各自基线评分可显著且独立地预测器官损害的增加。SLE、RA和健康对照者在2年期间健康状况测量结果的变化相似。
我们为期2年的SLE纵向观察性研究显示，健康状况和疾病活动度病程稳定，而器官损害增加。基线时的疾病活动度和器官损害可预测后者。我们的结果表明，在SLE中对疾病活动度进行长期仔细监测以及根据病程和结局预测因素进行个体化治疗具有重要价值。
