Hammad M, Eissa M, Fathi S
Faculty of medicine, Zagazig University, Zagazig, Egypt.
Faculty of medicine, Cairo University, Cairo, Egypt.
Lupus. 2016 Aug;25(9):1019-27. doi: 10.1177/0961203316636465. Epub 2016 Mar 7.
Systemic lupus erythematosus (SLE) is a prototypic multisystem autoimmune disorder. The total damage in a patient with SLE may result from SLE itself or from any other pathologic process. The aim of this study was to assess risk factors of greater damage in a sample of Egyptian SLE patients.
This Egyptian multicenter retrospective study included 100 SLE patients: 64 patients from Cairo University Hospitals and 36 patients from Zagazig University Hospitals. The Systemic Lupus International Collaborative Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (ACR-DI) was used to document the damage in each patient.
The total SLICC/ACR-DI score ranged from 0 to 8. A higher DI score was found in hypertensive patients, compared to normotensive patients; and among those with positive anti-phospholipid antibodies, compared to those with negative anti-phospholipid antibodies. This difference was statistically significant (p < 0.01). Also, a higher DI score was found in cyclophosphamide users, compared to non-users; and in those with proteinuria and seizures, compared to those without; and the difference was statistically significant (p < 0.05). There was a significant positive correlation between the DI and patient age (p < 0.05).
Damage in SLE cannot be prevented completely, as SLE disease is considered an aggressive disease treated by aggressive medications, but rheumatologists should try to minimize damage as much as possible to maintain the patients' health, functioning and general wellbeing.
系统性红斑狼疮(SLE)是一种典型的多系统自身免疫性疾病。SLE患者的总损伤可能源于SLE本身或任何其他病理过程。本研究的目的是评估埃及SLE患者样本中出现更大损伤的危险因素。
这项埃及多中心回顾性研究纳入了100例SLE患者:64例来自开罗大学医院,36例来自扎加齐格大学医院。采用系统性红斑狼疮国际协作临床研究(SLICC)/美国风湿病学会(ACR)损伤指数(ACR-DI)记录每位患者的损伤情况。
SLICC/ACR-DI总分范围为0至8。与血压正常的患者相比,高血压患者的DI评分更高;与抗磷脂抗体阴性的患者相比,抗磷脂抗体阳性的患者中DI评分更高。这种差异具有统计学意义(p < 0.01)。此外,与未使用环磷酰胺的患者相比,使用环磷酰胺的患者DI评分更高;与无蛋白尿和癫痫发作的患者相比,有蛋白尿和癫痫发作的患者DI评分更高,差异具有统计学意义(p < 0.05)。DI与患者年龄之间存在显著正相关(p < 0.05)。
由于SLE被认为是一种需用积极药物治疗的侵袭性疾病,SLE中的损伤无法完全预防,但风湿病学家应尽量减少损伤,以维持患者的健康、功能和总体幸福感。