Fellmann B, Grob P J
Schweiz Med Wochenschr. 1979 Sep 8;109(34):1237-50.
In a retrospective multicenter study 106 patients with systemic lupus erythematosis were analyzed who had had the disease for an average of 8.6 years, and from whom an average of 8 sera were tested within 3 years for current immunologic parameters. Cumulative clinical data showed arthropathies in 86% of the patients, exanthema (67%), cytopenia (58%), and involvement of the kidney (45%), lung (43%) and heart (24%). In at least 1 serum per patient the following immune abnormalities were found: antinuclear antibodies (98%), anti-native DNA (92%), low C3 (71%), low C4 (82%), circulated immunocomplexes (70%) and cold lymphocytotoxins (46%). A clinical score and an immunological score was introduced and the two items were compared: the immune data from a single serum do not provide long-range prognostic information. The present disease state is best reflected by the total immune score, C3 and C4 with, however, many exceptions. Within the disease course of some SLE patients, periods were observed during which no pathological immune serologic data are measureable. This phenomenon may pose diagnostic problems.
在一项回顾性多中心研究中,分析了106例系统性红斑狼疮患者,这些患者平均患病8.6年,在3年内平均每人检测8份血清以获取当前免疫参数。累积临床数据显示,86%的患者有关节病,67%有皮疹,58%有血细胞减少,45%有肾脏受累,43%有肺部受累,24%有心脏受累。在每位患者至少1份血清中发现了以下免疫异常:抗核抗体(98%)、抗天然DNA(92%)、低C3(71%)、低C4(82%)、循环免疫复合物(70%)和冷淋巴细胞毒素(46%)。引入了临床评分和免疫评分,并对这两项进行了比较:单次血清的免疫数据不能提供长期预后信息。当前疾病状态最好由总免疫评分、C3和C4反映,但也有许多例外情况。在一些系统性红斑狼疮患者的病程中,观察到有些时期无法检测到病理性免疫血清学数据。这种现象可能会带来诊断问题。