Jacobsen S, Petersen J, Ullman S, Junker P, Voss A, Rasmussen J M, Tarp U, Poulsen L H, van Overeem Hansen G, Skaarup B, Hansen T M, Pødenphant J, Halberg P
Department of Rheumatology at Copenhagen University Hospitals at Hvidovre Hospital, Hvidovre, Denmark.
Clin Rheumatol. 1998;17(6):468-77. doi: 10.1007/BF01451282.
A Danish multicentre study was undertaken of the manifestations, infections, thrombotic events, survival and predictive factors of survival in 513 Danish patients with systemic lupus erythematosus (SLE) according to the 1982 classification criteria of the American College of Rheumatology. The mean duration of follow-up was 8.2 years from diagnosis and 12.8 years from first symptom. This paper describes the most common clinical and laboratory manifestations and their relationship to sex and age at the time of onset and diagnosis. Cluster analysis revealed three clinically defined clusters at the time of disease onset. Cluster 1 (57% of patients) consisted of relatively elderly patients without nephropathy or malar rash, but with a high prevalence of discoid lesions. Cluster 2 (18%) consisted of patients with nephropathy, a third of whom also developed serositis and lymphopenia. The patients of the third cluster (25%) all had malar rash and half were photosensitive. Follow-up showed that the patients of cluster 2 developed azotaemia, large proteinuria, arterial hypertension and myositis significantly more often than did the rest of the patients, but the mortality was not increased. The risk of developing renal end-stage disease was highest in men with early-onset disease.
根据美国风湿病学会1982年分类标准，对513例丹麦系统性红斑狼疮（SLE）患者的临床表现、感染、血栓形成事件、生存率及生存预测因素进行了一项丹麦多中心研究。从诊断开始的平均随访时间为8.2年，从出现首个症状开始为12.8年。本文描述了最常见的临床和实验室表现及其与发病和诊断时性别及年龄的关系。聚类分析显示，在疾病发作时有三个临床定义的聚类。聚类1（占患者的57%）由相对年长的患者组成，无肾病或蝶形红斑，但盘状皮损患病率高。聚类2（占18%）由肾病患者组成，其中三分之一还出现了浆膜炎和淋巴细胞减少。第三聚类（占25%）的患者均有蝶形红斑，一半患者对光敏感。随访显示，聚类2的患者发生氮质血症、大量蛋白尿、动脉高血压和肌炎的频率明显高于其他患者，但死亡率未增加。早期发病的男性发生终末期肾病的风险最高。
