Pamuk O N, Akbay F G, Dönmez S, Yilmaz N, Calayir G B, Yavuz S
1Department of Rheumatology, Trakya University Medical Faculty, Turkey.
Lupus. 2013 Nov;22(13):1416-24. doi: 10.1177/0961203313499956. Epub 2013 Aug 8.
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with a variety of clinical features. Survival has become longer as a result of better treatment modalities and better supportive care. There is no information on survival of SLE patients in Turkey. We evaluated clinical features and survival in SLE patients in two rheumatology departments.
All SLE patients being followed up by the Department of Rheumatology, Trakya University Medical Faculty, and the Department of Rheumatology, Marmara University Medical Faculty, over the 1996-2012 period were included. Patients were diagnosed with SLE if they fulfilled at least four American College of Rheumatology (ACR) criteria. The clinical and laboratory features, mortality data were obtained from medical charts.
We had 428 SLE patients, and women (399 patients, 93.2%) far outnumbered men (29 patients, 6.8%). The mean age at the time of SLE diagnosis was 40.3 ± 12.4 years. The most frequent clinical manifestations were arthritis (76.9%) and photosensitivity (70.1%). Renal disease was present in 32.9% of patients and neurological involvement in 12.9% of patients. After a median follow-up of 60 months, 19 patients died. The most frequent causes of death were ischemic heart disease, chronic renal failure and sepsis. The rate of five-year survival was 96%; 10-year survival, 92%; and 15-year survival, 88.8%. Multivariate Cox analysis showed that serositis at the time of diagnosis, SLE disease activity index (SLEDAI) score 6, and autoimmune hemolytic anemia were independent prognostic factors.
Data from two centers in Northwestern Turkey show that the mortality rate for SLE is similar to the rate in Western countries.
系统性红斑狼疮（SLE）是一种具有多种临床特征的系统性自身免疫性疾病。由于治疗方式的改善和更好的支持性护理护理，患者存活时间变长。土耳其尚无关于SLE患者生存率的相关信息。我们评估了两个风湿病科中SLE患者的临床特征和生存率。
纳入1996年至2012年期间在特拉凯亚大学医学院风湿病科和马尔马拉大学医学院风湿病科接受随访的所有SLE患者。如果患者至少符合四项美国风湿病学会（ACR）标准，则诊断为SLE。临床和实验室特征、死亡率数据均从病历中获取。
我们共纳入428例SLE患者，女性（399例，93.2%）远多于男性（29例，6.8%）。SLE诊断时的平均年龄为40.3±12.4岁。最常见的临床表现为关节炎（76.9%）和光敏性（70.1%）。32.9%的患者存在肾脏疾病，12.9%的患者有神经系统受累。中位随访60个月后，19例患者死亡。最常见的死亡原因是缺血性心脏病、慢性肾衰竭和败血症。五年生存率为96%；十年生存率为92%；十五年生存率为88.8%。多因素Cox分析显示，诊断时的浆膜炎、SLE疾病活动指数（SLEDAI）评分≥6以及自身免疫性溶血性贫血是独立的预后因素。
来自土耳其西北部两个中心的数据表明，SLE的死亡率与西方国家相似。
