Gladman D D
University of Toronto, Ontario, Canada.
Curr Opin Rheumatol. 1993 Sep;5(5):587-95. doi: 10.1097/00002281-199305050-00006.
Several instruments have been developed to assess disease activity in systemic lupus erythematosus. Any study of a new laboratory measure, any therapeutic trial, and any study of outcome and prognosis should include one of these validated measures of disease activity. The treatment of lupus is far from ideal. A controlled trial of plasmapheresis showed no benefit over standard regimens in lupus nephritis. A long course of pulse cyclophosphamide was shown to be better than pulse methylprednisolone or a short course of intravenous pulse cyclophosphamide. Despite the lack of ideal therapy, the prognosis of lupus, including 15-year survival rates, has improved over the past 4 decades. Specific organ damage continues to be an issue. Infection and vascular disease have emerged as important factors. With improved survival, other outcome measures, including specific organ function and health status, must be considered.
已经开发出多种评估系统性红斑狼疮疾病活动度的工具。任何关于新实验室检测指标的研究、任何治疗试验以及任何关于结局和预后的研究都应纳入这些经过验证的疾病活动度测量指标中的一种。狼疮的治疗远非理想。一项血浆置换的对照试验表明，在狼疮性肾炎中，其效果并不优于标准治疗方案。结果显示，长疗程脉冲环磷酰胺比脉冲甲基强的松龙或短疗程静脉脉冲环磷酰胺效果更好。尽管缺乏理想的治疗方法，但在过去40年里，狼疮的预后，包括15年生存率，已经有所改善。特定器官损伤仍然是一个问题。感染和血管疾病已成为重要因素。随着生存率的提高，必须考虑其他结局指标，包括特定器官功能和健康状况。
