[系统性红斑狼疮：300例患者的临床与免疫学研究]
[Systemic lupus erythematosus: a clinical and immunological study of 300 patients].
作者信息
Font J, Pallarés L, Cervera R, Vivancos J, López-Soto A, Herrero C, Darnell A, Torras A, Mirapeix E, del Olmo J A
机构信息
Unidad de Enfermedades Autoinmunitarias Sistémicas (Servicio de Medicina Interna General), Hospital Clínic i Provincial, Barcelona.
出版信息
Med Clin (Barc). 1993 Apr 24;100(16):601-5.
BACKGROUND
The aims of the present study were to analyze the clinical and immunologic characteristics of a wide group of patients with systemic lupus erythematosus (SLE) and define homogeneous subgroups with their own characteristics.
METHODS
A prospective study of 300 patients diagnosed of SLE were studied. These patients were subdivided according to sex, age at the onset of the disease and immunologic profile. The statistical study was carried out by the chi (2), Fisher, Student's t and Mann-Whitney U tests.
RESULTS
The series was made up of 266 (89%) females and 34 (11%) males. The mean age at onset of the disease was 31.8 +/- 14.6 years. In 48 (16%) patients the first manifestations appeared after the age of 50. Males were shown to present a lower prevalence of arthritis (59% vs 82% in woman, p < 0.005) and malar rash (29% vs 50%, p < 0.05), but had more cutaneous discoid lesions (18% vs 3% p < 0.001). In patients in whom the disease appeared after the age of 50 a lower prevalence of arthritis was presented (67% vs 82% in patients of less than 50 years of age, p < 0.005), malar rash (23% vs 53%, p < 0.001) and nephropathy (21% vs 41%, p < 0.05), but had greater myositis (17% vs 6%, p < 0.01). The absence of antinuclear antibodies (ANA) and the presence of anti-ds DNA and anti-ENA antibodies were associated with differences in the prevalence of different clinical manifestations.
CONCLUSIONS
Sex, age and immunologic pattern in systemic lupus erythematosus permit the definition of homogeneous subgroups with their own characteristics: a) males present a lower prevalence of arthritis and malar rash, but a greater prevalence of cutaneous discoid lesions; b) patients over the age of 50 develop arthritis, malar rash and nephropathy with a lower prevalence but have a greater prevalence of myositis; c) patients without antinuclear antibodies and those with anti-ds DNA and anti-ENA antibodies present differences in the prevalences of different clinical manifestations.
背景
本研究旨在分析一大组系统性红斑狼疮（SLE）患者的临床和免疫学特征，并确定具有自身特点的同质亚组。
方法
对300例确诊为SLE的患者进行前瞻性研究。这些患者根据性别、发病年龄和免疫学特征进行细分。采用卡方检验、Fisher检验、学生t检验和曼-惠特尼U检验进行统计学分析。
结果
该系列包括266例（89%）女性和34例（11%）男性。疾病发病的平均年龄为31.8±14.6岁。48例（16%）患者的首发表现出现在50岁以后。男性的关节炎患病率较低（59%对女性的82%，p<0.005）和蝶形红斑患病率较低（29%对50%，p<0.05），但盘状皮肤病变较多（18%对3%，p<0.001）。在50岁以后发病的患者中，关节炎患病率较低（67%对年龄小于50岁患者的82%，p<0.005）、蝶形红斑患病率较低（23%对53%，p<0.001）和肾病患病率较低（21%对41%，p<0.05），但肌炎患病率较高（17%对6%，p<0.01）。抗核抗体（ANA）的缺失以及抗双链DNA和抗可提取核抗原（ENA）抗体的存在与不同临床表现的患病率差异相关。
结论
系统性红斑狼疮中的性别、年龄和免疫模式允许定义具有自身特点的同质亚组：a）男性关节炎和蝶形红斑的患病率较低，但盘状皮肤病变的患病率较高；b）50岁以上的患者发生关节炎、蝶形红斑和肾病的患病率较低，但肌炎的患病率较高；c）无抗核抗体的患者以及有抗双链DNA和抗ENA抗体的患者在不同临床表现的患病率上存在差异。
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