狼疮治疗与预后的差异。
Disparities in lupus care and outcomes.
作者信息
Demas Kristina L, Costenbader Karen H
机构信息
Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.
出版信息
Curr Opin Rheumatol. 2009 Mar;21(2):102-9. doi: 10.1097/BOR.0b013e328323daad.
Abstract
PURPOSE OF REVIEW
Systemic lupus erythematosus (SLE), an inflammatory rheumatic disease characterized by autoantibody production and diverse clinical manifestations, disproportionately affects vulnerable groups: women, racial and ethnic minorities, the poor and those lacking medical insurance and education. We summarize the current knowledge of the disparities observed in SLE and highlight recent research that aims to dissect the causes of these disparities and identify the potentially modifiable factors contributing to them.
RECENT FINDINGS
Several remediable causes, including lack of education, self-efficacy and access to quality, experienced healthcare have been found to contribute to observed disparities in SLE prevalence and outcomes.
SUMMARY
SLE is associated with alarming disparities in incidence, severity and outcomes. The causes of these disparities are under study by several research groups. Identifying potentially correctable contributory factors should allow the development of effective strategies to improve the healthcare delivery and outcomes in all SLE patients.
摘要
综述目的
系统性红斑狼疮（SLE）是一种炎症性风湿性疾病，其特征为自身抗体产生和多样的临床表现，对弱势群体的影响尤为严重，这些群体包括女性、种族和少数民族、贫困人口以及缺乏医疗保险和教育的人群。我们总结了目前关于SLE中观察到的差异的知识，并强调了最近旨在剖析这些差异的原因并确定导致这些差异的潜在可改变因素的研究。
最新发现
已发现一些可补救的原因，包括缺乏教育、自我效能感以及获得高质量的、有经验的医疗保健服务，这些因素导致了SLE患病率和预后方面观察到的差异。
总结
SLE在发病率、严重程度和预后方面存在令人担忧的差异。几个研究小组正在研究这些差异的原因。确定潜在的可纠正促成因素应有助于制定有效的策略，以改善所有SLE患者的医疗服务和预后。
相似文献
1
Disparities in lupus care and outcomes.狼疮治疗与预后的差异。
Curr Opin Rheumatol. 2009 Mar;21(2):102-9. doi: 10.1097/BOR.0b013e328323daad.
2
Use of Quality Measures to Identify Disparities in Health Care for Systemic Lupus Erythematosus.利用质量指标识别系统性红斑狼疮医疗保健中的差异。
Rheum Dis Clin North Am. 2020 Nov;46(4):623-638. doi: 10.1016/j.rdc.2020.07.003. Epub 2020 Sep 9.
3
Health Disparities in Systemic Lupus Erythematosus.系统性红斑狼疮中的健康差异。
Rheum Dis Clin North Am. 2020 Nov;46(4):673-683. doi: 10.1016/j.rdc.2020.07.010. Epub 2020 Sep 9.
4
Socioeconomic Status, Health Care, and Outcomes in Systemic Lupus Erythematosus.社会经济地位、医疗保健与系统性红斑狼疮结局。
Rheum Dis Clin North Am. 2020 Nov;46(4):639-649. doi: 10.1016/j.rdc.2020.07.004. Epub 2020 Sep 9.
5
A multiethnic, multicenter cohort of patients with systemic lupus erythematosus (SLE) as a model for the study of ethnic disparities in SLE.一个多民族、多中心的系统性红斑狼疮（SLE）患者队列，作为研究SLE种族差异的模型。
Arthritis Rheum. 2007 May 15;57(4):576-84. doi: 10.1002/art.22672.
6
Addressing health disparities as a function of ethnicity in systemic lupus erythematosus patients.解决系统性红斑狼疮患者中种族差异相关的健康差异问题。
Lupus. 2022 Dec;31(14):1691-1705. doi: 10.1177/09612033221122983. Epub 2022 Aug 29.
7
Increasing Ancestral Diversity in Lupus Trials: Ways Forward.增加狼疮试验中的祖先多样性：前进的道路。
Rheum Dis Clin North Am. 2020 Nov;46(4):713-722. doi: 10.1016/j.rdc.2020.07.011. Epub 2020 Sep 9.
8
Reframing health disparities in SLE: A critical reassessment of racial and ethnic differences in lupus disease outcomes.重新定义系统性红斑狼疮中的健康差异：对狼疮疾病结局的种族和民族差异进行批判性再评估。
Best Pract Res Clin Rheumatol. 2023 Dec;37(4):101894. doi: 10.1016/j.berh.2023.101894. Epub 2023 Dec 5.
9
The relationship of socioeconomic status, race, and modifiable risk factors to outcomes in patients with systemic lupus erythematosus.社会经济地位、种族和可改变的风险因素与系统性红斑狼疮患者预后的关系。
Arthritis Rheum. 1997 Jan;40(1):47-56. doi: 10.1002/art.1780400108.
10
Peer approaches to self-management (PALS): comparing a peer mentoring approach for disease self-management in African American women with lupus with a social support control: study protocol for a randomized controlled trial.同伴自我管理（PALS）：比较针对非裔美国狼疮女性疾病自我管理的同伴指导方法与社会支持对照：一项随机对照试验的研究方案。
Trials. 2019 Aug 23;20(1):529. doi: 10.1186/s13063-019-3580-4.
引用本文的文献
1
Association between social determinants of health and systemic lupus erythematosus: a nationally representative analysis of 2017-2021 data.健康的社会决定因素与系统性红斑狼疮之间的关联：对2017 - 2021年数据的全国代表性分析
Sci Rep. 2025 Aug 8;15(1):29095. doi: 10.1038/s41598-025-13071-7.
2
Associations of retention in care by visits or lupus-specific labs with acute care among young adults: A medicare cohort study.青年成年人中通过就诊或狼疮特异性实验室检查进行的持续护理与急性护理的关联：一项医疗保险队列研究。
Lupus. 2025 Jul 18:9612033251360289. doi: 10.1177/09612033251360289.
3
Increased prevalence, ER visits, and hospitalizations in medicare systemic lupus erythematosus patients living in socially vulnerable counties: A cross-sectional study.居住在社会弱势群体县的医疗保险系统性红斑狼疮患者患病率、急诊就诊率和住院率增加：一项横断面研究。
Am J Med Sci. 2025 Jun 12. doi: 10.1016/j.amjms.2025.05.009.
4
The unique challenges of childhood-onset systemic lupus erythematosus and lupus nephritis patients: a proposed framework for an individualized transitional care plan.儿童期起病的系统性红斑狼疮和狼疮性肾炎患者的独特挑战：个性化过渡护理计划的提议框架。
Pediatr Nephrol. 2025 Mar 13. doi: 10.1007/s00467-024-06654-5.
5
Effects of Demographic Identities on Psychosocial Burdens of Patients Living in the United States With Systemic Lupus Erythematosus.人口特征对美国系统性红斑狼疮患者心理社会负担的影响。
Cureus. 2024 Dec 3;16(12):e75043. doi: 10.7759/cureus.75043. eCollection 2024 Dec.
6
Challenges in Diagnosis and Management of SLE in Africa: An Online Survey.非洲系统性红斑狼疮诊断与管理中的挑战：一项在线调查。
ACR Open Rheumatol. 2025 Jan;7(1):e11749. doi: 10.1002/acr2.11749. Epub 2024 Oct 9.
7
Racial Disparities and Achievement of the Low Lupus Disease Activity State: A CARRA Registry Study.种族差异与低狼疮疾病活动状态的达成：一项CARRA注册研究
Arthritis Care Res (Hoboken). 2025 Jan;77(1):38-49. doi: 10.1002/acr.25443. Epub 2024 Oct 22.
8
Receipt of rheumatology care and lupus-specific labs among young adults with systemic lupus erythematosus: A US Medicare retention in care cohort study.红斑狼疮患者中青年人群的风湿病学治疗及狼疮特异性实验室检查：美国医疗保险保留治疗队列研究。
Lupus. 2024 Jul;33(8):804-815. doi: 10.1177/09612033241247905. Epub 2024 Apr 17.
9
A qualitative study on opportunities to improve research engagement and inclusion of Black adults with systemic lupus erythematosus.一项关于提高研究参与度和纳入患有系统性红斑狼疮的黑人群体的机会的定性研究。
Lupus. 2024 Jan;33(1):58-67. doi: 10.1177/09612033231220168. Epub 2023 Dec 4.
10
Cervical Health in Systemic Lupus Erythematosus.系统性红斑狼疮中的宫颈健康
Womens Health Rep (New Rochelle). 2023 Jul 12;4(1):328-337. doi: 10.1089/whr.2023.0023. eCollection 2023.
本文引用的文献
1
The role of neighborhood and individual socioeconomic status in outcomes of systemic lupus erythematosus.社区及个体社会经济地位在系统性红斑狼疮预后中的作用。
J Rheumatol. 2008 Sep;35(9):1782-8. Epub 2008 Jul 15.
2
Adverse pregnancy outcomes in women with systemic lupus erythematosus from a multiethnic US cohort: LUMINA (LVI) [corrected].来自美国多民族队列的系统性红斑狼疮女性的不良妊娠结局：LUMINA（LVI）[校正后]
Clin Exp Rheumatol. 2008 Mar-Apr;26(2):268-74.
3
Ethnic disparities among patients with systemic lupus erythematosus in South Carolina.南卡罗来纳州系统性红斑狼疮患者的种族差异。
J Rheumatol. 2008 May;35(5):819-25. Epub 2008 Mar 15.
4
Socioeconomic status and the incidence of ESRD.社会经济地位与终末期肾病的发病率
Am J Kidney Dis. 2008 Apr;51(4):563-72. doi: 10.1053/j.ajkd.2007.11.023. Epub 2008 Feb 7.
5
Associated factors and impact of myocarditis in patients with SLE from LUMINA, a multiethnic US cohort (LV). [corrected].来自美国多民族队列研究LUMINA（左心室）的系统性红斑狼疮患者心肌炎的相关因素及影响。[已校正]
Rheumatology (Oxford). 2008 Mar;47(3):362-7. doi: 10.1093/rheumatology/kem371. Epub 2008 Feb 4.
6
Avoidable hospitalizations in patients with systemic lupus erythematosus.系统性红斑狼疮患者中可避免的住院情况。
Arthritis Rheum. 2008 Feb 15;59(2):162-8. doi: 10.1002/art.23346.
7
Neighborhood poverty and racial differences in ESRD incidence.社区贫困与终末期肾病发病率的种族差异。
J Am Soc Nephrol. 2008 Feb;19(2):356-64. doi: 10.1681/ASN.2006080934. Epub 2007 Dec 5.
8
Articulating a justice ethic for rheumatology: A critical analysis of disparities in rheumatic diseases.阐述风湿病学的正义伦理：对风湿性疾病差异的批判性分析。
Arthritis Rheum. 2007 Dec 15;57(8):1343-5. doi: 10.1002/art.23110.
9
Poverty, not ethnicity, accounts for the differential mortality rates among lupus patients of various ethnic groups.造成不同种族狼疮患者死亡率差异的原因是贫困，而非种族。
J Natl Med Assoc. 2007 Oct;99(10):1196-8.
10
Hypertension and Afro-descendant ethnicity: a bad interaction for lupus nephritis treated with cyclophosphamide?高血压与非洲裔种族：对于接受环磷酰胺治疗的狼疮性肾炎而言是一种不良相互作用？
Lupus. 2007;16(9):724-30. doi: 10.1177/0961203307081114.
Zotero 插件