印度一家教学医院系统性红斑狼疮的死亡率：一项5年回顾性研究。

Mortality in systemic lupus erythematosus at a teaching hospital in India: A 5-year retrospective study.

作者信息

Bharath Gangadharaiah, Kumar Prabhat, Makkar Nayani, Singla Paras, Soneja Manish, Biswas Ashutosh, Wig Naveet

机构信息

Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.

出版信息

J Family Med Prim Care. 2019 Jul;8(7):2511-2515. doi: 10.4103/jfmpc.jfmpc_362_19.

DOI:10.4103/jfmpc.jfmpc_362_19

PMID:31463286

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6691451/

Abstract

OBJECTIVE

Systemic lupus erythematosus (SLE) is an autoimmune disease with an unknown etiology that can be life threatening. This study aimed to study the cause of mortality among admitted SLE patients over a period of 5 years at a teaching hospital in India.

METHODS

A 5-year retrospective analysis of mortality in SLE patients admitted under department of medicine of our institute was done. The presenting complaints, treatment history, clinical parameters, laboratory investigations, organ involvement, systemic lupus erythematosus disease activity index (SLEDAI), and cause of mortality were collected from the medical records on a predesigned proforma. A further analysis of two groups based on the cause of mortality was done.

RESULTS

In total, 53 death records were analyzed. Mortality in 28 SLE patients was due to high disease activity (Group I) and mortality in 25 patients was attributed due to both high disease activity and concomitant infection (Group II). Most of the patients were female (98%) and mean age of patient was 30.6 years. About 19 patients (35.8%) were diagnosed with SLE during hospital admission. Fever was the most common presenting complaint (69.8%) and lupus nephritis was the most common organ dysfunction seen (84.9%). Myocarditis was observed in 11 patients and 9 patients had cerebrovascular accident. The mean hemoglobin was lower in Group II (7.4 vs. 8.7 g/dL, = 0.02). The median total leukocyte count was significantly higher in Group II (10,200 vs. 6600, = 0.02). The mean serum urea and creatinine levels were also significantly higher in Group II (141.41 vs. 87.8 mg/dL, = 0.006 and 4.7 vs. 1.7, = 0.0001), respectively. The mean SLEDAI in Group I was 20.8 ± 8.9 and in Group II was17.7 ± 7.5. Bacterial pneumonia (17) was the most common infection, followed by tuberculosis (2) and fungal infection (2).

CONCLUSION

Mortality among SLE patients could be due to disease flare or concomitant infection. Lung is the most common organ affected by infection in these patients.

摘要

目的

系统性红斑狼疮（SLE）是一种病因不明的自身免疫性疾病，可危及生命。本研究旨在探讨印度一家教学医院5年间收治的SLE患者的死亡原因。

方法

对我院内科收治的SLE患者进行了为期5年的死亡率回顾性分析。根据预先设计的表格，从病历中收集患者的主诉、治疗史、临床参数、实验室检查、器官受累情况、系统性红斑狼疮疾病活动指数（SLEDAI）及死亡原因。根据死亡原因对两组患者进行了进一步分析。

结果

共分析了53份死亡记录。28例SLE患者死于疾病活动度高（第一组），25例患者死于疾病活动度高及合并感染（第二组）。大多数患者为女性（98%），患者平均年龄为30.6岁。约19例患者（35.8%）在住院期间被诊断为SLE。发热是最常见的主诉（69.8%），狼疮性肾炎是最常见的器官功能障碍（84.9%）。11例患者出现心肌炎，9例患者发生脑血管意外。第二组患者的平均血红蛋白水平较低（7.4 vs. 8.7 g/dL，P = 0.02）。第二组患者的中位数总白细胞计数显著较高（10200 vs. 6600，P = 0.02）。第二组患者的平均血清尿素和肌酐水平也显著较高（分别为141.41 vs. 87.8 mg/dL，P = 0.006和4.7 vs. 1.7，P = 0.0001）。第一组患者的平均SLEDAI为20.8±8.9，第二组为17.7±7.5。细菌性肺炎（17例）是最常见的感染，其次是肺结核（2例）和真菌感染（2例）。