Voulgari P V, Katsimbri P, Alamanos Y, Drosos A A
Rheumatology Clinic, Department of Internal Medicine, Medical Bchool, University of Ioannina, Ioannina, Greece.
Lupus. 2002;11(11):722-9. doi: 10.1191/0961203302lu253oa.
We investigated whether gender and age influence the clinical course and outcome in systemic lupus erythematosus (SLE) patients. Thus, we analyzed the clinical and laboratory data of 489 SLE patients at presentation and during follow-up. In addition, disease activity score (using the European Consensus Lupus Activity Measure, ECLAM) and organ damage index (using the Systemic Lupus International Collaboration Clinics/American College of Rheumatology Damage Index, DI) were measured. Furthermore, data from both sexes were analyzed according to the following age groups: < 55 years(younger group) and > 55 years (older group). There were 68 men and 421 women, giving a ratio of 1:7. We found no differences in the mean age, mean age at diagnosis, disease duration as well as duration of follow-up between men and women. Young men presented more frequently with serositis and discoid lesions, while women presented with Raynaud's phenomenon (RP) and malar rash. Regarding the laboratory findings, young women presented more often with anti-Ro(SSA) and anti-La(SSB) antibodies, while increased levels of erythrocyte sedimentation rate (ESR) were found in old women. During follow-up, men had serositis and renal disease more frequently, while the women's group were found to complain of RP, photosensitivity and mucosal ulcers more frequently, especially in young women.Anemia, leukopenia, thrombocytopenia and elevated levels of ESR were also found more frequently in young women during follow-up. However, there were no significant differences concerning ECLAM and DI scores between the two gender groups. Using multiple logistic regression analysis, a statistically significant association of malar rash, discoid lesions, serositis, RP, anti-Ro(SSA)/ La(SSB) and increased ESR with sex was found independently of age, while only malar rash showed a statistically significant association with age independently of sex. Thus, we conclude that gender influences the clinical expresion of the disease independently of age, while both gender and age do not affect the overall damage score.
我们研究了性别和年龄是否会影响系统性红斑狼疮（SLE）患者的临床病程及预后。因此，我们分析了489例SLE患者就诊时及随访期间的临床和实验室数据。此外，还测量了疾病活动评分（采用欧洲狼疮活动度共识测量法，即ECLAM）和器官损害指数（采用系统性红斑狼疮国际协作临床/美国风湿病学会损害指数，即DI）。此外，按照以下年龄组对两性数据进行了分析：<55岁（较年轻组）和>55岁（较年长组）。共有68名男性和421名女性，男女比例为1:7。我们发现，男性和女性在平均年龄、诊断时的平均年龄、病程以及随访时间方面并无差异。年轻男性更常出现浆膜炎和盘状红斑，而女性则表现为雷诺现象（RP）和蝶形红斑。关于实验室检查结果，年轻女性更常出现抗Ro（SSA）和抗La（SSB）抗体，而老年女性的红细胞沉降率（ESR）水平升高。在随访期间，男性更常出现浆膜炎和肾脏疾病，而女性组更常主诉有RP、光敏性和黏膜溃疡，尤其是年轻女性。在随访期间，年轻女性也更常出现贫血、白细胞减少、血小板减少和ESR水平升高。然而，两组在ECLAM和DI评分方面并无显著差异。通过多因素逻辑回归分析发现，蝶形红斑、盘状红斑、浆膜炎、RP、抗Ro（SSA）/La（SSB）以及ESR升高与性别存在统计学显著关联，且独立于年龄，而只有蝶形红斑显示出与年龄存在统计学显著关联，且独立于性别。因此，我们得出结论，性别独立于年龄影响疾病的临床表现，而性别和年龄均不影响总体损害评分。
