Osman Haidy M, Abdel-Nasser Ahmed M, Kasem Ahmed H, Elameen Nadia F, Omar Gihan M
Department of Rheumatology and Rehabilitation, 68877Minia University, Minya, Egypt.
Department of Chest Diseases, 68877Minia University, Minya, Egypt.
Lupus. 2023 Feb;32(2):198-206. doi: 10.1177/09612033221143934. Epub 2022 Dec 2.
Systemic lupus erythematosus (SLE) is a chronic multi-systemic autoimmune disease. SLE patients may experience a wide range of physical, psychological, and social perception of well-being influenced by the patient illness that are not always fully captured by descriptions of the disease's physiological consequences alone. Nowadays, patients with SLE have a better survival than decades ago, nevertheless still experience a low health related quality of life (HRQoL). Assessing disease activity in SLE is crucial to the physician as it forms the basis for treatment decisions, moreover careful evaluation for respiratory involvement should be routinely considered. More chronic lung disease related to SLE can have a significant negative effect on patient well-being and physical performance status and are detrimental to quality of life.
The aim of this study was to evaluate quality of life changes in SLE patients using Lupus QoL scale, assessing their correlation with different disease aspects particularly pulmonary manifestations and predictors for worse QoL.
Total of 60 SLE patients, who fulfilled the 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria, were enrolled in this study. Disease activity was measured by systemic lupus erythematosus disease activity index (SLEDAI) and quality of life was assessed by Lupus QoL. Pulmonary evaluation included pulmonary function tests parameters (PFTs), mMRC dyspnea scale, HRCT score, and pulmonary damage index.
Lupus QoL had a strong significant correlations with PFTs FEV1, FVC, and DLCO (r = 0.79, 0.78, 0.76, < .001), respectively}, while Lupus QoL had strong negative correlations with both mMRC dyspnea scale and HRCT score (r = -0.96, -0.85, < .001), respectively, and moderate negative correlation with neuropsychiatric lupus (NPSLE) (r = -0.61, < .001). Weak negative correlations were found between Lupus QoL, photosensitivity, alopecia, Raynaud's and renal affection (r = -0.29, -0.30, -0.30, 0.38, = .03, .02, .02, .002), respectively. NPSLE and pulmonary involvement were the most consistent predictors of low HRQoL [contributing 36% and 18% of the variance of Lupus QoL], respectively.
Lupus QoL is negatively correlated with different SLE clinical parameters particularly pulmonary manifestations. Neuropsychiatric, pulmonary, renal affection, and SLEDAI are the best determinants for worse Lupus QoL.
系统性红斑狼疮(SLE)是一种慢性多系统自身免疫性疾病。SLE患者可能会经历广泛的身体、心理和社会幸福感感知,这些受到患者疾病的影响,而仅通过对疾病生理后果的描述并不总能完全体现。如今,SLE患者的生存率比几十年前有所提高,但他们的健康相关生活质量(HRQoL)仍然较低。评估SLE中的疾病活动度对医生至关重要,因为它是治疗决策的基础,此外,应常规考虑对呼吸受累情况进行仔细评估。更多与SLE相关的慢性肺病会对患者的幸福感和身体功能状态产生显著负面影响,并对生活质量有害。
本研究的目的是使用狼疮生活质量量表评估SLE患者的生活质量变化,评估其与不同疾病方面尤其是肺部表现的相关性以及生活质量变差的预测因素。
共有60例符合2012年系统性红斑狼疮国际协作临床(SLICC)标准的SLE患者纳入本研究。通过系统性红斑狼疮疾病活动指数(SLEDAI)测量疾病活动度,通过狼疮生活质量量表评估生活质量。肺部评估包括肺功能测试参数(PFTs)、改良英国医学研究委员会(mMRC)呼吸困难量表、高分辨率计算机断层扫描(HRCT)评分和肺损伤指数。
狼疮生活质量量表与PFTs中的第1秒用力呼气容积(FEV1)、用力肺活量(FVC)和一氧化碳弥散量(DLCO)分别有很强的显著相关性(r = 0.79、0.78、0.76,P <.001),而狼疮生活质量量表与mMRC呼吸困难量表和HRCT评分均有很强的负相关性(r分别为 -0.96、-0.85,P <.001),与神经精神性狼疮(NPSLE)有中度负相关性(r = -0. June 1,< 001)。在狼疮生活质量量表与光敏性、脱发、雷诺现象和肾脏受累之间分别发现了较弱的负相关性(r分别为 -0.29、-0.30、-0.30、0.38,P =.03、.02、.02、.002)。NPSLE和肺部受累是低HRQoL最一致的预测因素[分别占狼疮生活质量量表方差的36%和18%]。
狼疮生活质量量表与不同的SLE临床参数尤其是肺部表现呈负相关。神经精神性、肺部、肾脏受累和SLEDAI是狼疮生活质量变差的最佳决定因素。