Gladman D D
Wellesley Hospital, Toronto, Ontario, Canada.
Curr Opin Rheumatol. 1991 Oct;3(5):789-96. doi: 10.1097/00002281-199110000-00007.
The prognosis of systemic lupus erythematosus has improved over the past four decades. Articles published in the past year continue to demonstrate this improved survival, both overall and in patients with renal disease. Several factors may be associated with improved survival, including earlier diagnosis, better treatment for systemic lupus erythematosus, and improved medical therapy in general. Hydroxychloroquine has now clearly been shown to prevent flares, and ancrod has been shown to improve renal disease in patients with glomerular thrombosis. Treatment with dialysis and transplantation resulted not only in improved survival but also in improved renal status, and reduction in overall disease activity. Specific organ damage continues to be an issue, primarily with regard to kidney disease and neurocognitive impairment. The inclusion of health status assessment in the evaluation of patients with lupus, and as an outcome measure, is discussed.
在过去的四十年里，系统性红斑狼疮的预后有所改善。过去一年发表的文章继续证明了这种生存率的提高，无论是总体生存率还是肾病患者的生存率。几个因素可能与生存率的提高有关，包括早期诊断、系统性红斑狼疮的更好治疗以及总体上改善的药物治疗。现已明确证明羟氯喹能预防病情发作，而抗栓酶已被证明能改善肾小球血栓形成患者的肾病。透析和移植治疗不仅提高了生存率，还改善了肾脏状况，并降低了总体疾病活动度。特定器官损伤仍然是一个问题，主要涉及肾脏疾病和神经认知障碍。本文讨论了在狼疮患者评估中纳入健康状况评估并将其作为一项结果指标的情况。
