Unidade de Terapia Intensiva, Departamento de Emergência, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Braz J Med Biol Res. 2011 Nov;44(11):1184-93. doi: 10.1590/s0100-879x2011007500132. Epub 2011 Oct 13.
Our objective was to compare the pattern of organ dysfunctions and outcomes of critically ill patients with systemic lupus erythematosus (SLE) with patients with other systemic rheumatic diseases (SRD). We studied 116 critically ill SRD patients, 59 SLE and 57 other-SRD patients. The SLE group was younger and included more women. Respiratory failure (61%) and shock (39%) were the most common causes of ICU admission for other-SRD and SLE groups, respectively. ICU length-of-stay was similar for the two groups. The 60-day survival adjusted for the groups' baseline imbalances was not different (P = 0.792). Total SOFA scores were equal for the two groups at admission and during ICU stay, although respiratory function was worse in the other-SRD group at admission and renal and hematological functions were worse in the SLE group at admission. The incidence of severe respiratory dysfunction (respiratory SOFA >2) at admission was higher in the other-SRD group, whereas severe hematological dysfunction (hematological SOFA >2) during ICU stay was higher in the SLE group. SLE patients were younger and displayed a decreased incidence of respiratory failure compared to patients with other-SRDs. However, the incidences of renal and hematological failure and the presence of shock at admission were higher in the SLE group. The 60-day survival rates were similar.
我们的目的是比较系统性红斑狼疮（SLE）与其他系统性风湿病（SRD）危重症患者的器官功能障碍模式和结局。我们研究了 116 例危重症 SRD 患者，其中 59 例为 SLE 患者，57 例为其他-SRD 患者。SLE 组更年轻，且女性更多。呼吸衰竭（61%）和休克（39%）分别是其他-SRD 和 SLE 组入住 ICU 的最常见原因。两组 ICU 住院时间相似。调整两组基线失衡因素后，60 天生存率无差异（P=0.792）。两组入院时和 ICU 期间的 SOFA 总分相等，但其他-SRD 组入院时呼吸功能较差，SLE 组入院时肾脏和血液功能较差。入院时其他-SRD 组严重呼吸功能障碍（呼吸 SOFA＞2）的发生率较高，而 SLE 组在 ICU 期间严重血液功能障碍（血液 SOFA＞2）的发生率较高。SLE 患者较年轻，与其他-SRD 患者相比，呼吸衰竭的发生率较低。然而，SLE 组入院时肾脏和血液衰竭以及休克的发生率更高。60 天生存率相似。
