卒中主要影響狼瘡患者的晚期死亡率
摘要:目的:由於目前針對狼瘡患者死亡原因的數據極少,此研究旨在評估係統性紅斑狼瘡(SLE)患者早期死亡(ED)和晚期死亡(LD)的原因,並確定已死亡的SLE患者的臨床特征。方法:我們對在2002年至2011年期間死亡的且曾經在薩格勒布大學醫院中心臨床免疫學和風濕病科定期隨訪的狼瘡患者進行研究分析。根據患病時間將患者分組為早期死亡組和晚期死亡組,並根據人口統計學特征、分類標準、器官損傷和死亡原因進行比較。結果:我們總共篩選出90名患者(其中68名女性),他們平均死亡年齡為58±15歲。最常見的死亡原因類別是心血管疾病(40%),其次是感染(33%)、活動性SLE(29%)和惡性腫瘤(17%)。除卒中外(卒中僅僅導致SLE診斷後約10年的死亡),早期死亡和晚期死亡的原因之間沒有顯著差異。在90名患者中隻有41人的死亡診斷中報告了SLE。結論:雖然卒中可發生在SLE的早期和晚期,但主要與晚期死亡相關。鑒於已死亡SLE患者的死亡證明中記錄的SLE比例較低,因此可能需要進一步的詳細記錄來評估SLE對死亡率的真實影響。
附原文:Aim To assess the causes of early death (ED) and late death (LD) in patients with systemic lupus erythematosus (SLE) and determine the features of deceased SLE patients followed-up in a single Croatian tertiary hospital center, because little if any data on causes of death(CODs) in SLE patients are available for Croatia.MethodWe identified SLE patients regularly followed-up at the Division of Clinical Immunology and Rheumatology, University Hospital Center Zagreb, who died from 2002 to 2011. Death was ascertained by matching our institutional records with the Croatian National Death Database. Patients were grouped according to their disease duration to ED and LD and compared by demographic characteristics, classification criteria, organ damage, and CODs.ResultsWe identified 90 patients (68 women), who died at the age of 58 ± 15 years. The most frequent COD category was cardiovascular diseases (40%), followed by infections (33%), active SLE (29%), and malignancies (17%). No significant difference was found between the frequencies of causes of ED and LD, except for stroke, which caused only LD≥10 years after the diagnosis. SLE was reported in death certificates of only 41 of 90 patients.ConclusionAlthough stroke occurred both in the early and late disease course, it was primarily associated with LD. Given the low proportion of SLE recorded in death certificates of deceased SLE patients, matching of institutional and vital statistics records may be required to assess the true impact of SLE on mortality.
引自:Ivan Padjen, MislavCerovecDisease characteristics and causes of early and late death in a group of Croatian patients with systemic lupus erythematosus deceased over a 10-year periodCroat Med J. 2018;59:3-12
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