巴西圣保罗州 1985 年至 2004 年系统性红斑狼疮死亡率趋势。

Trends in systemic lupus erythematosus mortality rates in the state of Sao Paulo, Brazil from 1985 to 2004.

机构信息

Universidade Federal de São Paulo, Brazil.

出版信息

Clin Exp Rheumatol. 2010 Jul-Aug;28(4):519-24. Epub 2010 Aug 30.

PMID:20659407

Abstract

OBJECTIVES

To estimate mortality rates and mortality trends from SLE in the state of São Paulo, Brazil.

MATERIAL AND METHODS

The official data bank was used to study all deaths occurred from 1985 to 2004 in which SLE was mentioned as the underlying cause of death. Besides the overall mortality rate, the annual gender- and age-specific mortality rates were estimated for each calendar year by age bracket (0-19 years, 20-39 years, 40-59 years and over 60 years) and for the sub-periods 1985-1995 (first) and 1996-2004 (second), by decades. Chi-square test was used to compare the mortality rates between the two periods, as well the mortality rates according to educational level considering years of study. Pearson correlation coefficient test was used to analyse mortality trends. The crude rates were adjusted for age by the direct method, using the standard Brazilian population in 2000.

RESULTS

A total of 2,601 deaths (90% female) attributed to SLE were analysed. The mean age at death was significantly higher in the second than in the first sub-period (36.6+/-15.6 years vs. 33.9+/-14.0 years; p<0.001). The overall adjusted mortality rate was 3.8 deaths/million habitants/year for the entire period and 3.4 deaths/million inhabitants/year for the first and 4.0 deaths/million inhabitants/year for the second sub-period (p<0.001). In each calendar year, the mortality rate was significantly lower for the better educated group. Throughout the period, there was a significant increase in mortality rates only among women over 40.

CONCLUSIONS

SLE patients living in the state of São Paulo still die at younger ages than those living in developed countries. Our data do not support the theory that there was an improvement in the SLE mortality rate in the last 20 years in the state of Sao Paulo. Socio-economic factors, such as the difficulty to get medical care and adequate treatment, may be the main factors to explain the worst prognosis for our patients.

摘要

目的

评估巴西圣保罗州系统性红斑狼疮（SLE）患者的死亡率和死亡率趋势。

材料和方法

使用官方数据库研究了 1985 年至 2004 年期间所有以 SLE 为根本死因的死亡病例。除了总体死亡率外，还按年龄组（0-19 岁、20-39 岁、40-59 岁和 60 岁以上）和亚时段（1985-1995 年[第一]和 1996-2004 年[第二]）逐年估算了每个日历年度的性别和年龄特异性死亡率。用卡方检验比较了两个时期的死亡率以及不同受教育程度（考虑学习年限）患者的死亡率。用皮尔逊相关系数检验分析死亡率趋势。直接法校正年龄因素，使用 2000 年巴西标准人口。

结果

共分析了 2601 例（90%为女性）SLE 死亡病例。与第一亚时段相比，第二亚时段的死亡年龄明显更高（36.6+/-15.6 岁 vs. 33.9+/-14.0 岁；p<0.001）。整个研究期间，校正年龄后死亡率的总体调整率为 3.8 例/百万居民/年，第一亚时段为 3.4 例/百万居民/年，第二亚时段为 4.0 例/百万居民/年（p<0.001）。在每个日历年度，受教育程度较好的人群死亡率明显较低。整个研究期间，只有 40 岁以上女性的死亡率呈显著上升趋势。