Alon U, Warady B A, Hellerstein S
University of Missouri, Kansas City School of Medicine.
Adv Pediatr. 1993;40:325-51.
The long-term outlook for the pediatric patient with lupus nephritis has improved dramatically over the past several decades. In 1968, Meislin and Rothfield compared childhood with adult SLE and found the prognosis to be worse when disease onset was at the age of 15 years or younger. Children with renal disease had only a 42% 5-year survival rate vs. an 82% survival rate in adults. Caeiro et al. found the 10-year survival rate in childhood to be only 48%. However, more recent data have demonstrated comparable results for patients of all ages. Ten-year patient survival rates have improved to 69% to 85% as a result of better immunosuppressive therapy, more effective antibiotics, and improved control of hypertension. Despite this overall improvement, severe renal disease continues to complicate the course of 20% to 35% of patients with SLE originating in childhood and demands further investigation of newer therapeutic measures.
在过去几十年里，狼疮性肾炎患儿的长期预后有了显著改善。1968年，梅斯林和罗斯菲尔德比较了儿童和成人系统性红斑狼疮（SLE），发现发病年龄在15岁及以下时，预后更差。患有肾脏疾病的儿童5年生存率仅为42%，而成人则为82%。凯罗等人发现儿童的10年生存率仅为48%。然而，最近的数据表明，各年龄段患者的结果相当。由于更好的免疫抑制治疗、更有效的抗生素以及高血压控制的改善，患者的10年生存率已提高到69%至85%。尽管总体情况有所改善，但严重肾脏疾病仍使20%至35%的儿童期起病的SLE患者病情复杂化，需要进一步研究更新的治疗措施。
