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):478-84. doi: 10.1007/BF01451283.
In this Danish multicentre study, predictive clinical factors of mortality and survival were calculated for 513 patients with systemic lupus erythematosus (SLE), 122 of whom died within a mean observation period of 8.2 years equalling a mortality rate of 2.9% per year. Survival rates were 97%, 91%, 76% and 64% after 1, 5, 10 and 15 years, respectively. The direct causes of death included SLE (n = 35), infections (n = 25), malignancy (n = 9), cardiovascular disease (n = 32) and other causes (n = 21). Uni- and multivariate analyses of survival and mortality were performed for all deaths and for SLE-related deaths. Azotaemia (one-fifth of the patients) was a strong predictor of increased overall and SLE-related mortality, but nephropathy per se (one-half of the patients) and large proteinuria (one-sixth of the patients) were unrelated to survival. Haemolytic anaemia had a significant negative influence on survival related to mortality caused by infections. Diffuse central nervous system disease and myocarditis were related to increased SLE-related mortality, whereas photosensitivity predicted a decreased mortality. Non-fatal infections and thrombotic events predicted a decreased overall survival. Since 1980 the mortality caused by SLE manifestations has decreased significantly.
在这项丹麦多中心研究中，对513例系统性红斑狼疮（SLE）患者的死亡和生存预测临床因素进行了计算，其中122例在平均8.2年的观察期内死亡，年死亡率为2.9%。1年、5年、10年和15年后的生存率分别为97%、91%、76%和64%。直接死亡原因包括SLE（n = 35）、感染（n = 25）、恶性肿瘤（n = 9）、心血管疾病（n = 32）和其他原因（n = 21）。对所有死亡病例和与SLE相关的死亡病例进行了生存和死亡率的单因素和多因素分析。氮质血症（五分之一的患者）是总体死亡率和与SLE相关死亡率增加的有力预测指标，但肾病本身（一半的患者）和大量蛋白尿（六分之一的患者）与生存无关。溶血性贫血对因感染导致的死亡率相关的生存有显著负面影响。弥漫性中枢神经系统疾病和心肌炎与SLE相关死亡率增加有关，而光敏性则预示死亡率降低。非致命性感染和血栓形成事件预示总体生存率降低。自1980年以来，由SLE表现导致的死亡率已显著下降。
