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中国南方某省552例系统性红斑狼疮患者的临床及免疫学特征

Clinical and immunological characteristics in 552 systemic lupus erythematosus patients in a southern province of China.

作者信息

Li Wen-Gen, Ye Zhi-Zhong, Yin Zhi-Hua, Zhang Ke

机构信息

Department of Rheumatology, Meizhou People's Hospital, Meizhou, Guangdong, China.

Department of Rheumatology, The Affiliated Futian Hospital of Guangdong Medical College, Shenzhen, Guangdong, China.

出版信息

Int J Rheum Dis. 2017 Jan;20(1):68-75. doi: 10.1111/1756-185X.12480. Epub 2015 Apr 10.

Abstract

AIM

The purpose of this study was to gain a better understanding of systemic lupus erythematosus (SLE) in Hakka populations.

METHODS

We studied the demographic, clinical and laboratory characteristics in a cohort of 552 SLE patients diagnosed at the Rheumatology Department in MeiZhou People's Hospital from January 2008 to December 2012. There were 495 women and 57 men (8.7 : 1) with a mean age of 35.3 years (range 12-78 years). The mean age at disease onset and the mean disease duration were 31.8 ± 14.4 years and 3.3 ± 2.8 years, respectively.

RESULTS

The most common clinical manifestations were arthritis (61.6%), followed by malar rash (52.7%), photosensitivity (22.8%), mouth ulcers (17.0%) and discoid lupus (14.7%). The prevalence was 46.7% for nephritis (by biopsy), 18.3% for pleuritis, 15.6% for pericarditis and 4.9% for neuropsychiatric manifestations. The most common hematological manifestations were anemia (63.8%), followed by leucopenia (29.0%) and thrombocytopenia (14.9%). Antinuclear antibodies were detected in 99.8% of patients, followed by anti-double-stranded DNA (81.3%), anti-SSA (Sjögren's syndrome antigen A)/Ro (58.7%), anti-ribonucleoprotein (36.8%), anti-Sm (35.7%), and anti-SSB/La (15.0%). Anti-cardiolipin immunoglobulin G (IgG) and IgM were detected in 18.3% and 14.1% of patients, respectively. Active disease and infections were the two major causes of death.

CONCLUSION

The clinical and immunological characteristics of the SLE patients in our study place our population in the middle of the spectrum between other Asian and Caucasian populations.

摘要

目的

本研究旨在更好地了解客家人群中的系统性红斑狼疮(SLE)。

方法

我们研究了2008年1月至2012年12月期间在梅州市人民医院风湿科确诊的552例SLE患者的人口统计学、临床和实验室特征。其中有495名女性和57名男性(8.7∶1),平均年龄为35.3岁(范围12 - 78岁)。疾病发病的平均年龄和平均病程分别为31.8±14.4岁和3.3±2.8年。

结果

最常见的临床表现为关节炎(61.6%),其次为颊部红斑(52.7%)、光过敏(22.8%)、口腔溃疡(17.0%)和盘状红斑狼疮(14.7%)。肾炎(经活检)的患病率为46.7%,胸膜炎为18.3%,心包炎为15.6%,神经精神表现为4.9%。最常见的血液学表现为贫血(63.8%),其次为白细胞减少(29.0%)和血小板减少(14.9%)。99.8%的患者检测到抗核抗体,其次为抗双链DNA(81.3%)、抗SSA(干燥综合征抗原A)/Ro(58.7%)、抗核糖核蛋白(36.8%)、抗Sm(35.7%)和抗SSB/La(15.0%)。分别在18.3%和14.1%的患者中检测到抗心磷脂免疫球蛋白G(IgG)和IgM。活动性疾病和感染是主要的死亡原因。

结论

我们研究中SLE患者的临床和免疫学特征表明,我们的人群处于其他亚洲和白种人群体范围的中间位置。

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