Alonso Maria D, Llorca Javier, Martinez-Vazquez Francisco, Miranda-Filloy Jose A, Diaz de Teran Teresa, Dierssen Trinidad, Vazquez-Rodriguez Tomas R, Gomez-Acebo Ines, Blanco Ricardo, Gonzalez-Gay Miguel A
From Divisions of Internal Medicine (MDA), Neurology (FM-V), and Rheumatology (JAM-F, TRV-R), Hospital Xeral-Calde, Lugo; Division of Preventive Medicine and Public Health, Division of Epidemiology and Computational Biology (IG-A, TD, JL), School of Medicine, University of Cantabria, Santander; CIBER Epidemiología y Salud Publica (CIBERESP), IFIMAV, Santander; and Divisions of Internal Medicine (TDdT) and Rheumatology (RB, MAG-G), Hospital Universitario Marques de Valdecilla, IFIMAV, Santander, Spain.
Medicine (Baltimore). 2011 Sep;90(5):350-358. doi: 10.1097/MD.0b013e31822edf7f.
To further investigate the epidemiology of systemic lupus erythematosus (SLE) in southern Europe, we assessed the incidence, prevalence, clinical spectrum of the disease, flares, and survival of patients diagnosed with SLE in the Lugo region of northwestern Spain. Between January 1987 and December 2006, 150 Lugo residents were diagnosed as having SLE according to the 1982 American College of Rheumatology criteria for the classification of SLE. Women outnumbered men (127 [84.7%] vs. 23 [15.3%]). The mean age at the time of disease diagnosis was 46.1 ± 19.6 years. The mean follow-up from the time of disease diagnosis was 7.8 ± 4.5 years. The age- and sex-adjusted annual incidence rate over the 20-year study period was 3.6 (95% confidence interval [CI], 3.0-4.2) per 100,000 population aged 15 years and older. The overall annual incidence rate over the 20-year study period in women (5.9/100,000 population aged ≥ 15 yr; 95% CI, 4.9-7.0) was higher than in men (1.1/100,000 population aged ≥ 15 yr; 95% CI, 0.7-1.7) (p < 0.001). By December 31, 2006, the overall age-adjusted SLE prevalence in the Lugo region for patients who fulfilled at least 4 of 1982 American College of Rheumatology criteria was 17.5 per 100,000 population aged 15 years and older (95% CI, 12.6-24.1). Prevalence in women (29.2/100,000 population aged ≥ 15 yr; 95% CI, 20.0-40.7) was higher than in men (5.8/100,000 population aged ≥ 15 yr; 95% CI, 2.0-12.0). The most frequent clinical manifestation was arthritis. As reported in population-based studies on SLE patients of European descent, renal disease was observed in only 27.3% of the patients. The rate of flares was 0.084/year. A younger age and the presence of nephritis at the time of disease diagnosis were associated with the development of flares during the follow-up of Lugo patients. Compared with the general population the probability of survival in patients with SLE was significantly reduced (p = 0.04). In conclusion, the present study establishes a baseline estimate of the incidence and clinical spectrum of SLE in northwestern Spain. According to our results, the incidence of SLE in northwestern Spain is slightly higher than that reported in most European regions. Patients with SLE from northwestern Spain have a later average age onset and a lower frequency of nephritis than in the African-American population. However, our data show a reduced probability of survival in Spanish patients with SLE.
为进一步研究欧洲南部系统性红斑狼疮（SLE）的流行病学情况，我们评估了西班牙西北部卢戈地区确诊为SLE患者的发病率、患病率、疾病临床谱、病情复发情况及生存率。1987年1月至2006年12月期间，根据1982年美国风湿病学会SLE分类标准，150名卢戈居民被诊断为患有SLE。女性人数多于男性（127例[84.7%]对23例[15.3%]）。疾病诊断时的平均年龄为46.1±19.6岁。从疾病诊断时起的平均随访时间为7.8±4.5年。在20年的研究期内，年龄和性别调整后的年发病率为每10万15岁及以上人口3.6例（95%置信区间[CI]，3.0 - 4.2）。20年研究期内女性的总体年发病率（5.9/10万≥15岁人口；95%CI，4.9 - 7.0）高于男性（1.1/10万≥15岁人口；95%CI，0.7 - 1.7）（p<0.001）。到2006年12月31日，在卢戈地区，至少符合1982年美国风湿病学会4项标准的患者，年龄调整后的SLE总体患病率为每10万15岁及以上人口17.5例（95%CI，12.6 - 24.1）。女性患病率（29.2/10万≥15岁人口；95%CI，20.0 - 40.7）高于男性（5.8/10万≥15岁人口；95%CI，2.0 - 12.0）。最常见的临床表现为关节炎。正如在欧洲裔SLE患者的人群研究中所报道的，仅27.3%的患者出现肾脏疾病。病情复发率为0.084/年。在卢戈患者的随访期间，较年轻的年龄以及疾病诊断时存在肾炎与病情复发的发生相关。与普通人群相比，SLE患者的生存概率显著降低（p = 0.04）。总之，本研究建立了西班牙西北部SLE发病率和临床谱的基线估计值。根据我们的结果，西班牙西北部SLE的发病率略高于大多数欧洲地区报道的发病率。西班牙西北部的SLE患者平均发病年龄较晚，肾炎发生率低于非裔美国人。然而，我们的数据显示西班牙SLE患者的生存概率降低。
