系统性红斑狼疮诊断时活动性盘状红斑狼疮和颧部皮疹的预后意义：一项前瞻性队列研究的结果

Prognostic implications of active discoid lupus erythematosus and malar rash at the time of diagnosis of systemic lupus erythematosus: Results from a prospective cohort study.

作者信息

Drucker A M, Su J, Mussani F, Siddha S K, Gladman D D, Urowitz M B

机构信息

Division of Dermatology, University Health Network, Toronto Western Hospital, Toronto, Canada

Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, University Health Network, Toronto Western Hospital, Toronto, Canada.

出版信息

Lupus. 2016 Apr;25(4):376-81. doi: 10.1177/0961203315610645. Epub 2015 Oct 8.

DOI:10.1177/0961203315610645

PMID:26453664

Abstract

OBJECTIVE

Cutaneous lupus erythematosus (CLE) may have prognostic implications for systemic lupus erythematosus (SLE). We aimed to determine the impact of discoid lupus erythematosus (DLE) and malar rash on SLE disease activity.

METHODS

Data were analyzed from the Toronto Lupus Clinic prospective cohort study. We compared SLE patients with active DLE or malar rash at SLE diagnosis to SLE patients who never developed CLE. Outcomes were assessed at one and five years, including Adjusted Mean Systemic Lupus Erythematosus Disease Activity Index 2000 (AMS).

RESULTS

A total of 524 SLE patients (284 without CLE, 65 with DLE, and 175 with malar rash) were included. Mean AMS scores in patients without CLE at one and five years were 5.96 ± 5.06 and 4.00 ± 3.52, which did not differ significantly from scores at one (6.93 ± 5.31, p = 0.17) and five years (4.29 ± 2.62, p = 0.63) in the DLE group. In patients with malar rash, AMS scores at one (8.30 ± 6.80, p < 0.001) and five years (5.23 ± 3.06, p = 0.004) were higher than controls without CLE.

CONCLUSIONS

Malar rash may be a marker of more severe systemic disease over time, while DLE has no significant impact on general SLE disease activity.

摘要

目的

皮肤型红斑狼疮（CLE）可能对系统性红斑狼疮（SLE）的预后有影响。我们旨在确定盘状红斑狼疮（DLE）和蝶形红斑对SLE疾病活动度的影响。

方法

对多伦多狼疮诊所前瞻性队列研究的数据进行分析。我们将SLE诊断时伴有活动性DLE或蝶形红斑的患者与从未发生过CLE的SLE患者进行比较。在1年和5年时评估结果，包括校正后的平均系统性红斑狼疮疾病活动指数2000（AMS）。

结果

共纳入524例SLE患者（284例无CLE，65例有DLE，175例有蝶形红斑）。无CLE的患者在1年和5年时的平均AMS评分分别为5.96±5.06和4.00±3.52，与DLE组1年（6.93±5.31，p = 0.17）和5年（4.29±2.62，p = 0.63）时的评分无显著差异。有蝶形红斑的患者在1年（8.30±6.80，p < 0.001）和5年（5.23±3.06，p = 0.004）时的AMS评分高于无CLE的对照组。