中国狼疮患者疾病活动性与浆膜炎相关
中国狼疮患者的疾病活动性与浆膜炎发展相关
目的：根据中国SLE治疗研究组（CSTAR）数据库的大型队列研究中国系统性红斑狼疮（SLE）患者浆膜炎的患病率和临床特征。
方法：根据CSTAR的数据进行了SLE患者的前瞻性横断面研究。 浆膜炎定义依据1999年修订的美国风湿病学会（ACR）SLE标准，即通过超声心动图，胸部X线检查或胸部电脑断层扫描（CT）扫描检测到胸膜炎/胸腔积液和/或心包炎/心包积液。腹膜炎/腹膜积液通过腹部超声检查证实。我们分析了浆膜炎的患病率和临床与人口学数据，器官受累情况，实验室检查和SLE疾病活动的关系。
结果：在2104例SLE患者中，345例诊断为浆膜炎。狼疮性肾炎（LN），间质性肺病和肺动脉高压的患病率，以及白细胞减少症，血小板减少症，低补体血症和抗dsDNA抗体的患病率显著高于浆膜炎患者（P <0.05）。 与没有浆膜炎的患者相比，浆膜炎患者的SLE疾病活动评分显著升高（P <0.05）。 狼疮相关腹膜炎具有与SLE引起的浆膜炎相似的临床表现和实验室特征。
结论：肾病，间质性肺病，肺动脉高压，低补体血症，白细胞减少症，血小板减少症和升高的抗dsDNA抗体与浆膜炎有显著的关联。 结果表明，较高的SLE疾病活动与浆膜炎发展相关，应积极治疗。
附原文：
OBJECTIVE: To investigate both the prevalence and clinical characteristics of serositis in Chinese patients with systemic lupus erythematosus (SLE) in a large cohort in the Chinese SLE Treatment and Research group (CSTAR) database.
METHODS: A prospective cross-sectional study of patients with SLE was conducted based on the data from the CSTAR registry. Serositis was defined according to the 1999 revised American College of Rheumatology (ACR) criteria for SLE - that is, pleuritis/pleural effusion and/or pericarditis/pericardial effusion detected by echocardiography, chest X-ray or chest computerized tomography (CT) scan. Peritonitis/peritoneal effusion were confirmed by abdominal ultrasonography. We analysed the prevalence and clinical associations of serositis with demographic data, organ involvements, laboratory findings and SLE disease activity.
RESULTS:Of 2104 patients with SLE, 345 were diagnosed with serositis. The prevalence of lupus nephritis (LN), interstitial lung disease and pulmonary arterial hypertension, as well as the presence of leukocytopenia, thrombocytopenia, hypocomplementemia and anti-dsDNA antibodies was significantly higher in patients with serositis (P < 0.05). Significantly higher SLE disease activity scores were found in patients with serositis compared to those patients without serositis (P < 0.05). Lupus-related peritonitis had similar clinical manifestations and laboratory profiles as serositis caused by SLE.
CONCLUSION:There is a significant association of nephropathy, interstitial lung disease, pulmonary arterial hypertension, hypocomplementemia, leukocytopenia, thrombocytopenia and elevated anti-dsDNA antibodies with serositis. The results suggest that higher SLE disease activity contributes to serositis development, and should be treated aggressively.
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