Halberg P, Bendixen G, Fugleberg S, Jørgensen F, Kriegbaum N J, Lorenzen I, Müller K, Olesen K M, Rasmussen E, Ullman S
Hvidovre Hospital, København, reumatologisk og nefrologisk afdeling.
Ugeskr Laeger. 1991 Jun 10;153(24):1705-9.
Sixty-one of 173 patients with systemic lupus erythematosus followed for a mean of 13.9 years had severe infections which influenced their survival more than could be accounted for by the mortality (20 per cent) caused by the infections. Patients with infections had more SLE manifestations than patients without infections, and they died of lupus manifestations more often than patients without infections. Patients who went into a permanent remission and patients who died of lupus differed most markedly by the rates of infection. The rate of infection was increased more than tenfold in patients treated with high dosages of glucocorticoid compared with patients who received low dosages. Treatment with cytostatics influenced the rate of infections to a moderate degree. Nephropathy also influenced survival but half of the patients with nephropathy maintained a normal plasma creatinine in spite of the long observation period. 16 per cent of the patients with nephropathy died of kidney failure or are receiving chronic hemodialysis.
173例系统性红斑狼疮患者平均随访13.9年，其中61例发生严重感染，这些感染对其生存的影响超过了感染所致死亡率（20%）所能解释的范围。感染患者比未感染患者有更多的系统性红斑狼疮表现，且死于狼疮表现的频率高于未感染患者。病情永久缓解的患者与死于狼疮的患者在感染率方面差异最为显著。与接受低剂量糖皮质激素治疗的患者相比，接受高剂量糖皮质激素治疗的患者感染率增加了10倍以上。细胞抑制剂治疗对感染率有中度影响。肾病也影响生存，但尽管观察期很长，仍有一半的肾病患者血浆肌酐维持正常。16%的肾病患者死于肾衰竭或正在接受慢性血液透析。
