Hopkinson N D, Doherty M, Powell R J
Department of Immunology, Queen's Medical Centre, Nottingham, United Kingdom.
Ann Rheum Dis. 1994 Oct;53(10):675-80. doi: 10.1136/ard.53.10.675.
To assess race-specific incidence and prevalence rates for systemic lupus erythematosus (SLE) using 1991 National Census data and to ascertain the frequency of clinical/laboratory features of a geographically complete cohort of patients with SLE.
Multiple methods of retrieval were used to ascertain SLE patients including screening request cards for immunology investigations. Patients were classified according to the revised ARA criteria. Multiple logistic regression analysis was used to study the effects of age at diagnosis on the frequency of clinical/laboratory SLE features.
The overall one year period prevalence rate for SLE was 24.7 (age adjusted, 95% CI: 20.7-28.8)/100,000. Highest rates were seen in Afro-Caribbeans (207 (111-302)/100,000), followed by Asians (48.8 (10.5-87.1)/100,000), and then Whites (20.3 (16.6-24.0)/100,000). The mean age at diagnosis of SLE was 40.9 years (range: 11-83) with a mean interval between first definite SLE symptom and diagnosis of 61 months (0-518). In 85% of patients the first definite lupus feature was musculoskeletal and/or cutaneous. In this SLE cohort renal disease (22%) was observed less commonly than in previous studies and the 'classic' butterfly rash was present in only 30% of patients. Malar rash, thrombocytopaenia, positive anti-dsDNA antibodies, hypocomplementaemia (C4), and positive IgG anticardiolipin antibodies were all seen less commonly with increasing age at diagnosis.
A closer estimate of the true frequency of clinical/laboratory SLE manifestations is likely from this geographically complete cohort of patients compared with studies that may be skewed by referral patterns.
利用1991年全国人口普查数据评估系统性红斑狼疮（SLE）的种族特异性发病率和患病率，并确定一个地理范围完整的SLE患者队列的临床/实验室特征频率。
采用多种检索方法来确定SLE患者，包括免疫检查的筛查申请卡。患者根据修订的美国风湿病学会（ARA）标准进行分类。采用多元逻辑回归分析来研究诊断时年龄对SLE临床/实验室特征频率的影响。
SLE的总体一年期患病率为24.7（年龄调整后，95%可信区间：20.7 - 28.8）/100,000。最高患病率见于非洲加勒比人（207（111 - 302）/100,000），其次是亚洲人（48.8（10.5 - 87.1）/100,000），然后是白人（20.3（16.6 - 24.0）/100,000）。SLE诊断时的平均年龄为40.9岁（范围：11 - 83岁），首次明确的SLE症状与诊断之间的平均间隔为61个月（0 - 518个月）。85%的患者首个明确的狼疮特征是肌肉骨骼和/或皮肤方面的。在这个SLE队列中，肾脏疾病（22%）的发生率低于以往研究，只有30%的患者出现“典型”蝶形红斑。随着诊断时年龄的增加，颧部红斑、血小板减少、抗双链DNA抗体阳性、补体降低（C4）和IgG抗心磷脂抗体阳性的发生率均降低。
与可能因转诊模式而有偏差的研究相比，这个地理范围完整的患者队列可能能更准确地估计SLE临床/实验室表现的真实频率。
