系统性红斑狼疮的全球发病率和患病率:流行病学研究的系统评价
The worldwide incidence and prevalence of systemic lupus erythematosus: a systematic review of epidemiological studies.
作者信息
Rees Frances, Doherty Michael, Grainge Matthew J, Lanyon Peter, Zhang Weiya
机构信息
Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham.
Rheumatology Department, Nottingham University Hospitals NHS Trust.
出版信息
Rheumatology (Oxford). 2017 Nov 1;56(11):1945-1961. doi: 10.1093/rheumatology/kex260.
OBJECTIVES
The aim was to review the worldwide incidence and prevalence of SLE and variation with age, sex, ethnicity and time.
METHODS
A systematic search of MEDLINE and EMBASE search engines was carried out using Medical Subject Headings and keyword search terms for Systemic Lupus Erythematosus combined with incidence, prevalence and epidemiology in August 2013 and updated in September 2016. Author, journal, year of publication, country, region, case-finding method, study period, number of incident or prevalent cases, incidence (per 100 000 person-years) or prevalence (per 100 000 persons) and age, sex or ethnic group-specific incidence or prevalence were collected.
RESULTS
The highest estimates of incidence and prevalence of SLE were in North America [23.2/100 000 person-years (95% CI: 23.4, 24.0) and 241/100 000 people (95% CI: 130, 352), respectively]. The lowest incidences of SLE were reported in Africa and Ukraine (0.3/100 000 person-years), and the lowest prevalence was in Northern Australia (0 cases in a sample of 847 people). Women were more frequently affected than men for every age and ethnic group. Incidence peaked in middle adulthood and occurred later for men. People of Black ethnicity had the highest incidence and prevalence of SLE, whereas those with White ethnicity had the lowest incidence and prevalence. There appeared to be an increasing trend of SLE prevalence with time.
CONCLUSION
There are worldwide differences in the incidence and prevalence of SLE that vary with sex, age, ethnicity and time. Further study of genetic and environmental risk factors may explain the reasons for these differences. More epidemiological studies in Africa are warranted.
目的
本研究旨在综述系统性红斑狼疮(SLE)在全球范围内的发病率、患病率及其随年龄、性别、种族和时间的变化情况。
方法
2013年8月,利用医学主题词以及“系统性红斑狼疮”与“发病率”“患病率”“流行病学”相关的关键词检索词,对MEDLINE和EMBASE搜索引擎进行系统检索,并于2016年9月更新。收集作者、期刊、发表年份、国家、地区、病例发现方法、研究时期、发病或患病病例数、发病率(每10万人年)或患病率(每10万人)以及特定年龄、性别或种族组的发病率或患病率。
结果
SLE发病率和患病率的最高估计值出现在北美[分别为23.2/10万人年(95%可信区间:23.4,24.0)和241/10万人(95%可信区间:130,352)]。非洲和乌克兰报告的SLE发病率最低(0.3/10万人年),北澳大利亚的患病率最低(847人的样本中为0例)。在各个年龄和种族组中,女性比男性更易患病。发病率在中年达到峰值,男性发病较晚。黑人种族的人群SLE发病率和患病率最高,而白人种族的人群发病率和患病率最低。SLE患病率似乎随时间呈上升趋势。
结论
SLE的发病率和患病率在全球范围内存在差异,且随性别、年龄、种族和时间而变化。对遗传和环境风险因素的进一步研究可能解释这些差异的原因。非洲有必要开展更多的流行病学研究。