Zonana-Nacach A, Salas M, Sánchez M L, Camargo-Coronel A, Bravo-Gatica C, Mintz G
Departmento de Reumatología, Instituto Mexicano del Serguro Social (IMSS), Mexico DF.
J Rheumatol. 1995 Jan;22(1):45-9.
To assess flares in outpatients with systemic lupus erythematosus (SLE) using SLAM (systemic lupus activity measure) and to determine laboratory abnormalities as predictors of disease activity.
Fifty-three Mexican patients were assessed using SLAM scale. They were evaluated monthly for a total of at least 572 months. The SLAM scale was applied at each visit. Samples were drawn for complete blood cell count, erythrocyte sedimentation rate, urinalysis, 24-h protein and creatinine clearance, anti-DNA, C3 and C4. An SLE flare was defined as the occurrence of new clinical manifestations or worsening compared to the previous month that usually required restarting or increasing prednisone or immunosuppressive drugs.
Thirty-three patients had flares, mainly in minor organs. The incidence of flares was 0.69/patient/year of followup. Active nephritis and extrarenal manifestations correlated with high levels of dsDNA and low complement levels. We found an odds ratio (OR) = 3 (CI = 1.7-5.7) for flare in asymptomatic patients with high dsDNA and OR = 2 (CI = 1.3-4.5) for low C3 levels.
Flares are frequent in patients with SLE and they occur independent of disease duration and the time the disease has been under control. Flares are apparently predictable and are related to serologic abnormalities.
使用系统性红斑狼疮活动度测量（SLAM）评估系统性红斑狼疮（SLE）门诊患者的病情复发，并确定实验室异常指标作为疾病活动的预测因素。
采用SLAM量表对53例墨西哥患者进行评估。每月对他们进行评估，共计至少572个月。每次就诊时应用SLAM量表。采集样本进行全血细胞计数、红细胞沉降率、尿液分析、24小时蛋白和肌酐清除率、抗DNA、C3和C4检测。SLE病情复发定义为与前一个月相比出现新的临床表现或病情恶化，通常需要重新开始使用或增加泼尼松或免疫抑制药物。
33例患者出现病情复发，主要累及次要器官。病情复发的发生率为0.69/患者/年随访时间。活动性肾炎和肾外表现与高dsDNA水平和低补体水平相关。我们发现，dsDNA水平高的无症状患者病情复发的比值比（OR）=3（可信区间[CI]=1.7-5.7），C3水平低的患者病情复发的OR=2（CI=1.3-4.5）。
SLE患者病情复发频繁，且与疾病持续时间和疾病得到控制的时间无关。病情复发显然是可预测的，并且与血清学异常有关。
