中国香港六种风湿性疾病的预期寿命、标准化死亡率及死因

Life expectancy, standardized mortality ratios, and causes of death in six rheumatic diseases in Hong Kong, China.

作者信息

Mok C C, Kwok C L, Ho L Y, Chan P T, Yip S F

机构信息

Tuen Mun Hospital, Hong Kong, China.

出版信息

Arthritis Rheum. 2011 May;63(5):1182-9. doi: 10.1002/art.30277.

DOI:10.1002/art.30277

PMID:21391198

Abstract

OBJECTIVE

To examine the life expectancy, standardized mortality ratios (SMRs), and causes of death in 6 groups of patients from Hong Kong with different rheumatic diseases.

METHODS

Patients with a diagnosis of systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), systemic vasculitis (SV), or systemic sclerosis (SSc) registered in 37 public hospitals between 1999 and 2008 were identified in the hospital registry. SMRs were calculated by comparing the mortality rate in patients with each disease with that in the general population. Life expectancy was calculated by abridged life-table analysis, and the causes of death were compared.

RESULTS

In 2008, data on 8,367 RA, 5,243 SLE, 2,154 AS, 1,636 SV, 778 PsA, and 449 SSc patients were available in our registry. The age- and sex-adjusted SMRs were highest for SLE (5.25 [95% confidence interval 4.79-5.70]), SSc (3.94 [95% confidence interval 3.20-4.68]), and SV (2.64 [95% confidence interval 2.36-2.93]). In female patients, the loss in life expectancy was greatest for SSc (34.1 years), SV (19.3 years), and SLE (19.7 years). In male patients, the loss in life expectancy was highest for SV (28.3 years), SLE (27 years), and SSc (16 years). There were 2,486 deaths during the study period (1999-2008), and the principal causes were infections (28%), cardiovascular complications (18%), cancer (16%), and disease activity (7%). Infection was the leading cause of death in SLE, RA, AS, and PsA, whereas deaths from disease-related activity and cardiovascular complications were most frequent in SSc. Cancer was the most common cause of death in SV.

CONCLUSION

Our findings indicate that patients with SLE, RA, AS, PsA, SV, and SSc have increased mortality rates and reduced life expectancy. SLE has the highest adjusted SMR, and female SSc patients have the greatest loss in life expectancy. Infection is the leading cause of death, followed by cardiovascular complications and malignancies.

摘要

目的

研究香港6组不同风湿性疾病患者的预期寿命、标准化死亡率（SMR）及死亡原因。

方法

通过医院登记系统识别1999年至2008年期间在37家公立医院登记的系统性红斑狼疮（SLE）、类风湿关节炎（RA）、强直性脊柱炎（AS）、银屑病关节炎（PsA）、系统性血管炎（SV）或系统性硬化症（SSc）患者。通过比较每种疾病患者的死亡率与普通人群的死亡率来计算SMR。通过简略寿命表分析计算预期寿命，并比较死亡原因。

结果

2008年，我们的登记系统中有8367例RA患者、5243例SLE患者、2154例AS患者、1636例SV患者、778例PsA患者和449例SSc患者的数据。年龄和性别调整后的SMR在SLE（5.25[95%置信区间4.79 - 5.70]）、SSc（3.94[95%置信区间3.20 - 4.68]）和SV（2.64[95%置信区间2.36 - 2.93]）中最高。在女性患者中，SSc（34.1年）、SV（19.3年）和SLE（19.7年）的预期寿命损失最大。在男性患者中，SV（28.3年）、SLE（27年）和SSc（16年）的预期寿命损失最高。研究期间（1999 - 2008年）有2486例死亡，主要原因是感染（28%）、心血管并发症（18%）、癌症（16%）和疾病活动（7%）。感染是SLE、RA、AS和PsA的主要死亡原因，而与疾病相关活动和心血管并发症导致的死亡在SSc中最为常见。癌症是SV最常见的死亡原因。