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系统性红斑狼疮的研究进展:一项回顾性观察研究的临床特征、自身抗体和与性别相关的差异。

Insights into systemic lupus erythematosus: a retrospective observational study of clinical features, autoantibodies, and gender-related differences.

机构信息

Department of Internal Medicine, Division of Rheumatology, University of Jordan, Amman, Jordan.

Department of Rheumatology, AlBashir Hospital, Amman, Jordan.

出版信息

Rheumatol Int. 2024 Jul;44(7):1255-1263. doi: 10.1007/s00296-024-05592-7. Epub 2024 May 8.

Abstract

This study aims to analyze the clinical and immunologic features of SLE in Jordan, while also investigating the impact of age and gender on disease presentation. The study included 275 patients diagnosed with SLE. Data were collected through meticulous patient interviews and thorough examination of patient hospital records. The cohort exhibited a mean age of 36.8 ± 12.9 years, with an average disease duration of 7.0 ± 7.8 years. The mean age at diagnosis was 29.9 ± 12.1 years, and the female to male ratio was 7.8:1. The most frequently observed symptoms were arthralgia (90.2%), fatigue (80.7%), hematologic manifestations (62%), photosensitivity (60.7%), Raynaud's phenomenon (53.5%), and malar rash (50.9%). The frequencies of various autoantibodies were as follows: ANA (96.7%), anti-dsDNA (39.6%), anti-SSA/Ro (32.8%), anti-Sm (21.8%), anti-U1-RNP (20.6%), and anti-SSB/La (15.5%). Male patients tended to receive a diagnosis at a younger age and exhibited a higher likelihood of experiencing severe manifestations compared to females. Additionally, juvenile onset patients demonstrated an increased likelihood of fever, photosensitivity, myositis, and anti-dsDNA autoantibodies, while adult onset patients were more predisposed to having anti-Ro, anti-La, and RF autoantibodies. This study reveals that the most prevalent manifestations of SLE in the Jordanian cohort encompassed arthralgia, fatigue, and hematologic manifestations. The prevalence of alopecia and Raynaud's phenomenon exceeded that observed in other published cohorts, while arthritis and discoid rash were less frequently encountered. The study highlights that males are more susceptible to developing severe manifestations of SLE compared to females.

摘要

本研究旨在分析约旦系统性红斑狼疮(SLE)的临床和免疫学特征,并探讨年龄和性别对疾病表现的影响。该研究纳入了 275 名确诊为 SLE 的患者。通过详细的患者访谈和全面的病历检查收集数据。该队列的平均年龄为 36.8±12.9 岁,平均病程为 7.0±7.8 年。平均诊断年龄为 29.9±12.1 岁,男女比例为 7.8:1。最常见的症状为关节痛(90.2%)、疲劳(80.7%)、血液学表现(62%)、光过敏(60.7%)、雷诺现象(53.5%)和蝶形红斑(50.9%)。各种自身抗体的频率如下:ANA(96.7%)、抗 dsDNA(39.6%)、抗 SSA/Ro(32.8%)、抗 Sm(21.8%)、抗 U1-RNP(20.6%)和抗 SSB/La(15.5%)。男性患者的诊断年龄较小,且比女性更易出现严重表现。此外,幼年发病患者发热、光过敏、肌炎和抗 dsDNA 自身抗体的发生率较高,而成人发病患者更易出现抗 Ro、抗 La 和 RF 自身抗体。本研究表明,约旦队列中 SLE 最常见的表现为关节痛、疲劳和血液学表现。脱发和雷诺现象的发生率高于其他已发表的队列,而关节炎和盘状红斑的发生率较低。研究表明,男性比女性更易发生严重的 SLE 表现。

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