Abu-Shakra M, Urowitz M B, Gladman D D, Gough J
University of Toronto, Lupus Clinic, Wellesley Hospital, ON, Canada.
J Rheumatol. 1995 Jul;22(7):1259-64.
To study the causes of death in patients with SLE, followed prospectively in a single center.
The study population comprised 665 patients with systemic lupus erythematosus (SLE). Causes of death were determined by review of hospital files, autopsy reports, and death certificates. Nonparametric lifetable models were used to calculate Kaplan-Meier estimates of survival probabilities.
One hundred and twenty-four patients (18.6%) had died. The primary causes of death were active SLE in 20 (16%), infection in 40 (32%), acute vascular event in 19 (15.4%), sudden death in 10 (8.1%), organ failure in 6 (4.8%), malignancy in 8 (6.5%), others in 8 (6.5%), and unknown in 13 (10.5%). Death as a result of active SLE was more common in patients who died within 5 years of diagnosis compared to those dying after 5 years (p = 0.021), and deaths due to vascular events and end organ failure not related to active lupus were more frequent in the late death group (p = 0.028). The overall 5, 10, 15, and 20 year survival rates were 93, 85, 79, and 68%, respectively. Patients with SLE had a 4.92 fold increased risk for death compared with the general population.
Survival rates continue to improve in SLE but causes of mortality vary at different stages.
在单一中心对系统性红斑狼疮（SLE）患者进行前瞻性随访，研究其死亡原因。
研究人群包括665例系统性红斑狼疮患者。通过查阅医院病历、尸检报告和死亡证明来确定死亡原因。使用非参数生命表模型计算生存概率的Kaplan-Meier估计值。
124例患者（18.6%）死亡。主要死亡原因包括活动性SLE 20例（16%）、感染40例（32%）、急性血管事件19例（15.4%）、猝死10例（8.1%）、器官衰竭6例（4.8%）、恶性肿瘤8例（6.5%）、其他8例（6.5%）、原因不明13例（10.5%）。与诊断后5年以上死亡的患者相比，诊断后5年内死亡的患者中因活动性SLE导致的死亡更为常见（p = 0.021），晚期死亡组中因血管事件和与活动性狼疮无关的终末器官衰竭导致的死亡更为频繁（p = 0.028）。总体5年、10年、15年和20年生存率分别为93%、85%、79%和68%。SLE患者的死亡风险比普通人群高4.92倍。
SLE患者的生存率持续提高，但不同阶段的死亡原因有所不同。
