Swaak A J, Nieuwenhuis E J, Smeenk R J
Department of Rheumatology, Dr. Daniel den Hoed Cancer Center, Rotterdam, The Netherlands.
Rheumatol Int. 1992;12(2):71-5. doi: 10.1007/BF00300980.
In the past decades the general concept of the disease course and the prognosis of systemic lupus erythematosus (SLE) has changed dramatically. The improvement in prognosis of our SLE patients is often said to be related to the growing awareness of the disease. This study focussed on whether or not the clinical features at the onset of the disease, and at diagnosis, and the clinical course as well as the age at the onset of the disease had changed during the past decades. No obvious differences were observed in the age at the onset of the disease or in the age at diagnosis. Of the 22 clinical signs studied, only the prevalence of Raynaud's phenomenon at the onset of the disease had increased during the past 20 years. At diagnosis, the prevalence of oral ulcers and false positive syphilis test had decreased. Only small differences in the type but not in the number of exacerbations were observed; in the past 20 years, the prevalence of renal involvement increased from 20% to 43%. However, this was not significant. Our results did not support the theory that during the past 2 decades the disease had changed in its expression, neither did we find that the disease is presently diagnosed at an earlier age, as would be expected from the increased awareness of the disease.
在过去几十年中，系统性红斑狼疮（SLE）的疾病进程和预后的总体概念发生了巨大变化。人们常说，我们的SLE患者预后的改善与对该疾病认识的不断提高有关。本研究重点关注在过去几十年中，疾病发作时、诊断时的临床特征、临床病程以及疾病发作年龄是否发生了变化。在疾病发作年龄或诊断年龄方面未观察到明显差异。在研究的22种临床体征中，在过去20年中，仅疾病发作时雷诺现象的患病率有所增加。在诊断时，口腔溃疡和梅毒试验假阳性的患病率有所下降。在发作类型上仅观察到细微差异，但发作次数没有差异；在过去20年中，肾脏受累的患病率从20%增至43%。然而，这并不显著。我们的结果不支持在过去20年中该疾病的表现发生了变化这一理论，我们也未发现目前该疾病能在更早的年龄被诊断，而这是人们从对该疾病认识的提高中所预期的。
