Mayer Miroslav
Zavod za klinicku imunologiju i reumatologiju, Klinika za unutarnje bolesti, Klinicki bolnicki centar Zagreb, Kispatićeva 12, 10000 Zagreb.
Reumatizam. 2009;56(2):44-9.
The paper gives a brief overview of trends in mortality from lupus, risk factors and causes of death. At the end of the compressed mortalitetnim modest knowledge about the characteristics of SLE in Croatia and proposed measures for its reduction. Despite the significant decline of specific mortality rates, which captures the 50th year to date, long-term survival of patients is not satisfactory. Accelerated atherosclerosis with cerebrovascular and cardiovascular complications, infections and diseases zlocudne the most important causes of death in SLE. Race, age, gender, ethnicity, social and economic status of patients and the characteristics of the disease, primarily lupus nephritis, treatment and environmental influences, the factors affecting the mortality. In Croatia, the overall mortality rate of a specific axis of SLE is low, but there is a clear excess preuranjenih death and excess mortality in comparison with neighboring Slovenia. Therefore, in conclusion, the proposals amount to measures to reduce mortality: recognition and aggressive treatment of traditional and non-classical risk factors of atherosclerosis, reduction of disease activity with the least possible use of non-steroidal glucocorticoids ii antireumatika, adequate treatment of lupus nephritis, timely antiagregacijska and antikoagulacijska therapy in patients with increased risk thromboembolic incidents and patients with antiphospholipid syndrome. Educational and organizational measures to improve the availability and quality of health care affected by the centralization of the most difficult patients.
本文简要概述了狼疮死亡率的趋势、风险因素及死亡原因。在压缩死亡率部分末尾,对克罗地亚系统性红斑狼疮(SLE)的特征及降低死亡率的建议措施有适度了解。尽管特定死亡率显著下降,截至第50年,但患者的长期生存率仍不尽人意。加速性动脉粥样硬化伴脑血管和心血管并发症、感染及恶性疾病是SLE最重要的死亡原因。种族、年龄、性别、民族、患者的社会和经济状况以及疾病特征,主要是狼疮性肾炎、治疗和环境影响等因素,都会影响死亡率。在克罗地亚,SLE特定轴的总体死亡率较低,但与邻国斯洛文尼亚相比,存在明显的过早死亡和超额死亡率。因此,总之,降低死亡率的建议措施包括:识别并积极治疗动脉粥样硬化的传统和非经典风险因素,尽可能少用非甾体类糖皮质激素和抗风湿药降低疾病活动度,充分治疗狼疮性肾炎,对血栓栓塞事件风险增加的患者及抗磷脂综合征患者及时进行抗聚集和抗凝治疗。通过集中管理最困难的患者来采取教育和组织措施,以提高医疗服务的可及性和质量。