Petri M
Division of Molecular and Clinical Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD 21205.
Curr Opin Rheumatol. 1994 Sep;6(5):481-6. doi: 10.1097/00002281-199409000-00005.
Case reports, case series, and analytical clinical research studies continue to define and refine our understanding of the clinical presentation of lupus and its evolution over time. Major areas of interest in the past year have included malignancies, osteoporosis, neonatal lupus, central nervous system lupus, pregnancy, and renal disease. New emphasis has been placed on the importance of gynecologic malignancies in systemic lupus erythematosus. Osteoporosis, especially the role of corticosteroid therapy in the development of osteoporosis, remains a controversial area, particularly in premenopausal women. The poor outcome of many infants with neonatal lupus has been documented in several reports. A more sensitive brain imaging test for central nervous system lupus--brain single photon emission computed tomography--has been introduced. The effect of pregnancy on disease activity and the appropriate use of second-line agents in pregnancy have been reviewed. The importance of hypertension and other clinical variables in predicting renal outcome (as opposed to reliance on renal biopsy findings) was emphasized in two studies.
病例报告、病例系列以及分析性临床研究不断界定并完善我们对狼疮临床表现及其随时间演变的理解。过去一年的主要关注领域包括恶性肿瘤、骨质疏松症、新生儿狼疮、中枢神经系统狼疮、妊娠及肾脏疾病。过去一年新的重点在于妇科恶性肿瘤在系统性红斑狼疮中的重要性。骨质疏松症，尤其是皮质类固醇疗法在骨质疏松症发生中的作用，仍然是一个有争议的领域，在绝经前女性中尤为如此。多篇报告记录了许多新生儿狼疮患儿的不良预后。一种用于中枢神经系统狼疮的更敏感的脑成像检查——脑单光子发射计算机断层扫描——已被引入。妊娠对疾病活动的影响以及妊娠期间二线药物的合理使用已得到综述。两项研究强调了高血压及其他临床变量在预测肾脏预后（相对于依赖肾活检结果）方面的重要性。
