系统性红斑狼疮患者不同性别临床特征的对比研究(1)
[摘要] 目的 對比确诊为系统性红斑狼疮(Systemic lupus erythematosus，SLE)的患者中不同性别的临床特征及其治疗效果、预后的差异。 方法 选取中国人民解放军联勤保障部队第九四〇医院风湿免疫科从2005年1月～2014年1月住院期间所有的SLE患者进行回顾性研究。观察患者的发病年龄、发病特点，分析系统性红斑狼疮患者不同性别的临床表现、对各脏器功能的损害程度、实验室差异、经药物治疗后的效果及生存率的差异。 结果 回顾性分析发现，男性SLE狼疮患者生存率低于女性患者(P<0.05)，激素及免疫抑制剂的使用明显高于女性(P<0.05)。男性SLE患者脱发及盘状红斑的发生率较女性患者低(P<0.05)。但女性患者白细胞减少及自身抗体阳性率更为突出(P<0.001)。在疾病终末期需要透析的狼疮肾炎患者中，男性患者的风险明显高于女性患者(OR，3.98;95%置信区间，1.07～14.97)。男性与女性的SLICC/ACR DI(分别为1.55±0.26和1.03±0.42，P=0.028)。 结论 通过回顾性分析，本研究进一步证实，在系统性红斑狼疮患者中，男性狼疮性肾病的发生率比女性患者更高、损害程度比女性患者更为严重，男性一旦确诊SLE，总体预后及生存率较女性差。
[关键词] 系统性红斑狼疮;肾炎;性别;预后
[中图分类号] R593.241 [文献标识码] B [文章编号] 1673-9701(2020)13-0100-05
[Abstract] Objective To compare the differences in the clinical characteristics， therapeutic effects and prognosis of different sexes in the patients diagnosed with systemic lupus erythematosus(SLE). Methods All patients with SLE during the hospitalization period from January 2005 to January 2014 were selected from the Department of Rheumatology and Immunology in No. 940 Hospital of Joint Logistics Support Force of the PLA and were retrospectively studied. The age of onset and the characteristics of the disease were observed， and the differences in clinical manifestations， the degree of damage to various organ functions， laboratory differences， the therapeutic effects after medication and the survival rates were analyzed in different sexes of patients with systemic lupus erythematosus. Results According to retrospective analysis， the survival rate of male SLE patients was lower than that of female patients(P<0.05). The use of hormones and immunosuppressants in male patients was significantly higher than that in female patients(P<0.05). The incidence of hair loss and discoid erythema in male SLE patients was lower than that in female patients(P<0.05). However， leukopenia and autoantibody positive rates were more prominent in female patients(P<0.001). Among patients with lupus nephritis requiring dialysis at the terminal phase of the disease， the risk was significantly higher in male patients than in female patients(OR， 3.98; 95% confidence interval， 1.07-14.97). SLICC/ACR DI for males and females were(1.55±0.26) and(1.03±0.42)， respectively(P=0.028). Conclusion Through retrospective analysis， this study further confirms that in the patients with systemic lupus erythematosus， the incidence of lupus nephropathy in male patients is higher than that in female patients， and the degree of damage is more severe than in female patients. Once males are diagnosed with SLE， the overall prognosis and survival rate are worse than those in females., http://www.100md.com(牛小娟 吴海娟 李艳)
[关键词] 系统性红斑狼疮;肾炎;性别;预后
[中图分类号] R593.241 [文献标识码] B [文章编号] 1673-9701(2020)13-0100-05
[Abstract] Objective To compare the differences in the clinical characteristics， therapeutic effects and prognosis of different sexes in the patients diagnosed with systemic lupus erythematosus(SLE). Methods All patients with SLE during the hospitalization period from January 2005 to January 2014 were selected from the Department of Rheumatology and Immunology in No. 940 Hospital of Joint Logistics Support Force of the PLA and were retrospectively studied. The age of onset and the characteristics of the disease were observed， and the differences in clinical manifestations， the degree of damage to various organ functions， laboratory differences， the therapeutic effects after medication and the survival rates were analyzed in different sexes of patients with systemic lupus erythematosus. Results According to retrospective analysis， the survival rate of male SLE patients was lower than that of female patients(P<0.05). The use of hormones and immunosuppressants in male patients was significantly higher than that in female patients(P<0.05). The incidence of hair loss and discoid erythema in male SLE patients was lower than that in female patients(P<0.05). However， leukopenia and autoantibody positive rates were more prominent in female patients(P<0.001). Among patients with lupus nephritis requiring dialysis at the terminal phase of the disease， the risk was significantly higher in male patients than in female patients(OR， 3.98; 95% confidence interval， 1.07-14.97). SLICC/ACR DI for males and females were(1.55±0.26) and(1.03±0.42)， respectively(P=0.028). Conclusion Through retrospective analysis， this study further confirms that in the patients with systemic lupus erythematosus， the incidence of lupus nephropathy in male patients is higher than that in female patients， and the degree of damage is more severe than in female patients. Once males are diagnosed with SLE， the overall prognosis and survival rate are worse than those in females., http://www.100md.com(牛小娟 吴海娟 李艳)
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