Department of Medicine, Division of Clinical Immunology and Rheumatology, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA.
Lupus. 2010 May;19(6):727-33. doi: 10.1177/0961203309359289. Epub 2010 Jan 29.
The objectives of the present study were (1) to clarify and quantify the relationship between age and disease duration with the rate of change in disease activity over time in patients with systemic lupus erythematosus (SLE) and (2) to explore other possible factors associated with this rate of change. To this end, SLE patients from LUMINA were studied if they had at least three visits in which disease activity (Systemic Lupus Activity Measure-Revised [SLAM-R]) had been ascertained. Variables associated with the rate (slope) of change in disease activity (obtained by regressing the SLAM-R score against the length of time from diagnosis to visit date) were examined by univariable and multivariable analyses. Five hundred and forty two of the 632 patients had at least three SLAM-R score. In multivariable analyses, Whites exhibited the fastest decline in disease activity, Texan Hispanics exhibited the slowest, trailed by the African Americans. Longer disease duration and HLA-DRB1*1503 positivity were associated with a slower decline whereas a greater number of American College of Rheumatology criteria and abnormal laboratory parameters (white blood cell counts, hematocrit and serum creatinine) were associated with a faster decline. These findings complement existing knowledge on SLE disease activity and are potentially useful to clinicians managing these patients.
(1) 阐明并量化年龄和疾病持续时间与系统性红斑狼疮（SLE）患者疾病活动随时间变化率之间的关系；(2) 探讨与该变化率相关的其他可能因素。为此，如果 LUMINA 中的 SLE 患者在至少三次就诊时确定了疾病活动（修订后的系统性红斑狼疮活动度衡量标准 [SLAM-R]），则对其进行研究。通过单变量和多变量分析，检查与疾病活动变化率（通过将 SLAM-R 评分与从诊断到就诊日期的时间长度进行回归来获得）相关的变量。在多变量分析中，白人表现出疾病活动下降最快，德克萨斯州西班牙裔下降最慢，其次是非裔美国人。较长的疾病持续时间和 HLA-DRB1*1503 阳性与下降较慢相关，而更多的美国风湿病学会标准和异常实验室参数（白细胞计数、血细胞比容和血清肌酐）与下降较快相关。这些发现补充了现有关于 SLE 疾病活动的知识，并且对于管理这些患者的临床医生具有潜在的用处。
