Raj Rishi, Murin Susan, Matthay Richard A, Wiedemann Herbert P
Department of Pulmonary and Critical Care Medicine, Cleveland Clinic Foundation, Desk A-90, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Crit Care Clin. 2002 Oct;18(4):781-803. doi: 10.1016/s0749-0704(02)00024-6.
SLE causes significant morbidity and mortality by multisystem organ involvement. Infections are the leading cause of morbidity and mortality in patients with SLE. Meticulous exclusion of infection is mandatory in patients with SLE, because infections may masquerade as exacerbation of underlying disease; and the immunosuppression used to treat severe forms of exacerbation of lupus can have catastrophic consequences in patients with infections. Corticosteroids are the first-line therapy for most noninfectious complications of SLE, with various adjuvant immunosuppressive agents such as cyclophosphamide being increasingly used in combination with plasmapheresis. Some recent series have shown an improved survival rate, but this improvement needs to be confirmed by further studies. Controlled trials comparing various therapeutic options are lacking, and optimal therapy has not been defined.
系统性红斑狼疮（SLE）通过多系统器官受累导致显著的发病率和死亡率。感染是SLE患者发病和死亡的主要原因。对SLE患者必须仔细排除感染，因为感染可能伪装成基础疾病的加重；而用于治疗严重狼疮加重形式的免疫抑制在感染患者中可能产生灾难性后果。糖皮质激素是SLE大多数非感染性并发症的一线治疗药物，各种辅助免疫抑制剂如环磷酰胺越来越多地与血浆置换联合使用。最近的一些系列研究显示生存率有所提高，但这一改善需要进一步研究证实。缺乏比较各种治疗选择的对照试验，尚未确定最佳治疗方案。
