中国系统性红斑狼疮治疗与研究协作组（CSTAR）注册研究：五、性别对中国系统性红斑狼疮患者的影响

Chinese SLE Treatment and Research group (CSTAR) registry: V. gender impact on Chinese patients with systemic lupus erythematosus.

作者信息

Zhang S, Su J, Li X, Zhang X, Liu S, Wu L, Ma L, Bi L, Zuo X, Sun L, Huang C, Zhao J, Li M, Zeng X

机构信息

Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China.

Department of Rheumatology, the Second Hospital of Shanxi Medical University, Shanxi, China.

出版信息

Lupus. 2015 Oct;24(12):1267-75. doi: 10.1177/0961203315585813. Epub 2015 May 13.

DOI:10.1177/0961203315585813

PMID:25972364

Abstract

INTRODUCTION

Many studies have shown that differences were observed between male and female lupus patients. Although systemic lupus erythematosus (SLE) affects mostly females (female:male ratio 9:1), male SLE patients show higher mortality due to kidney and neurological disease. Currently there are limited epidemiological data concerning lupus in the Chinese population. As such, the Chinese SLE Treatment and Research group (CSTAR) developed the first online registry of Chinese lupus patients in 2009, and represents a multicenter observational study that attempts to describe and compile the major clinical characteristics of lupus in Chinese patients.

OBJECTIVE

To investigate the effect of gender on the phenotypes of Chinese SLE patients.

PATIENTS AND METHODS

Data for 2104 SLE patients were prospectively collected and included in the CSTAR registry. Patients fulfilled the 1997 American College of Rheumatology (ACR) SLE classification criteria. We conducted a cross-sectional case-control study to analyze patient clinical and laboratory data at onset and at enrollment. SLE disease activity scores (SLEDAI) were also measured at enrollment.

RESULTS

This study included 1914 women and 190 men. Males and females showed no differences in mean ages at onset, delay of diagnosis and disease duration. Males presented more frequently with fever (p = 0.003), while musculoskeletal involvement (p = 0.001) and cytopenia (p = 0.017) was more common in females as the initial manifestation at onset of SLE. For manifestations at enrollment, males presented more frequently with fever (p = 0.005), renal disease (p = 0.019), vasculitis (p = 0.032) and neuropsychiatric lupus (p = 0.007). For cumulative manifestations at enrollment, males presented more frequently with discoid rash (p < 0.001) and neuropsychiatric lupus (p = 0.036), while less frequently with arthritis (p = 0.011). However, the laboratory data showed no significant differences between the two groups at enrollment. Males also had higher SLEDAI scores at enrollment (p = 0.002).

CONCLUSIONS

Renal disease, vasculitis and neuropsychiatric lupus are more common in male SLE patients with higher SLEDAI scores compared to female SLE patients in China.

摘要

引言

许多研究表明，男性和女性狼疮患者之间存在差异。虽然系统性红斑狼疮（SLE）主要影响女性（女性与男性比例为9:1），但男性SLE患者因肾脏和神经系统疾病导致的死亡率更高。目前，关于中国人群狼疮的流行病学数据有限。因此，中国SLE治疗与研究组（CSTAR）于2009年建立了首个中国狼疮患者在线登记系统，这是一项多中心观察性研究，旨在描述和汇总中国患者狼疮的主要临床特征。

目的

探讨性别对中国SLE患者表型的影响。

患者与方法

前瞻性收集2104例SLE患者的数据并纳入CSTAR登记系统。患者符合1997年美国风湿病学会（ACR）SLE分类标准。我们进行了一项横断面病例对照研究，以分析患者发病时和入组时的临床及实验室数据。入组时还测量了SLE疾病活动评分（SLEDAI）。

结果

本研究包括1914名女性和190名男性。男性和女性在发病时的平均年龄、诊断延迟和病程方面无差异。男性发热更为常见（p = 0.003），而肌肉骨骼受累（p = 0.001）和血细胞减少（p = 0.017）在女性中作为SLE发病时的初始表现更为常见。对于入组时的表现，男性发热更为常见（p = 0.005）、肾脏疾病（p = 0.019）、血管炎（p = 0.032）和神经精神性狼疮（p = 0.007）。对于入组时的累积表现，男性盘状红斑更为常见（p < 0.001）和神经精神性狼疮（p = 0.036），而关节炎则较少见（p = 0.011）。然而，两组入组时的实验室数据无显著差异。男性入组时的SLEDAI评分也更高（p = 0.002）。