中华皮肤科杂志 ›› 2006, Vol. 39 ›› Issue (1): 3-6.

• 论著 • 上一篇    下一篇

光暴露及光防护措施与系统性红斑狼疮临床病情相关性研究

陈昆, 鞠梅, 顾恒, 常宝珠, 郑家润   

  1. 中国医学科学院、中国协和医科大学皮肤病医院 南京 210042
  • 收稿日期:2004-12-29 发布日期:2006-01-15

Relationship of sunlight exposure and photoprotection with clinical activity in systemic erythematosus

CHEN Kun, JU Mei, GU Heng, CHANG Bao-zhu, ZHENG Jia-run   

  1. Institute of Dermatology, Chinese Academy of Medical Sciences, Peking Union Medical College, Nanjing 210042, China
  • Received:2004-12-29 Published:2006-01-15

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摘要： 目的 探讨系统性红斑狼疮患者的日光暴露时间及光防护措施与其病情的相关性.方法 询问107例系统性红斑狼疮患者日光暴露及光防护措施的态度及行为,并对患者的临床表现、实验室检查指标及治疗予以评估.结果 48例(44.86%)患者每日光暴露<1h,59例(55.14%)患者每日光暴露≥1h.24例(22.43%)患者春、夏两季外出时采取光防护措施.每日光暴露<1h组患者光敏感性、关节痛、脱发、疾病活动、抗dsDNA抗体、C3<800mg/L、C4<180mg/L及CH50<90kU/L的发生率明显低于每日光暴露≥1h组的患者(P<0.05).肾脏受累的发生率两组差异无统计学意义,但前者肾受累的严重程度(尿蛋白>+++)明显低于后者(P<0.01).每日光暴露<1h组治疗使用硫酸羟氯喹片、中高剂量醋酸泼尼松片及联合环磷酰胺冲击治疗的频率均低于每日光暴露≥1h组.治疗后面部蝶形红斑、发热、关节痛及抗核抗体的改善,两组差异无统计学意义,但尿蛋白转阴天数前者明显短于后者(P<0.05).结论 系统性红斑狼疮患者应减少过度日光暴露,加强光防护措施.

关键词: 日光防护, 红斑狼疮,系统性, 日光暴露

Abstract: Objective To study the relationship of sunlight exposure and photoprotection with clinical activity in systemic lupus erythematosus.Methods A structured questionaire was administered to 107 SLE patients,to assess their attitudes and behavior regarding sunlight exposure and photoprotection.The clinical manifestations,laboratory findings and treatment were evaluated.Results All patients were classified into two groups based on the duration of exposure to sunlight per day.Fourty-eight (44.86%) patients were exposed to direct sunlight for an average of less than one hour per day in one group and 59 (55.14%) for one hour or more in the other group.Twenty-four (22.43%) patients reported use of photoprotective measures in spring and summer.The patients in the former group had significantly lower incidences of photosensitivity,arthritis,alopecia,exacerbations,presence of anti-dsDNA antibody,decrease of complement C3,C4 and CH50 than those in the latter group(P<0.05).The incidence of renal involvement was not different between the two groups.But the severity of renal involvement was lower in the former group than that in the latter (P<0.01).The former group required hydroxychloroquine,middle to high dose of corticosteroid and CTX pulse treatment less frequently than the latter group to control the disease.After the treatment there was no significant difference in the improvement of malar rash,fever,arthralgia and ANA between the two groups.But it took significantly shorter time for the urine protein test to turn negative in the former group than that in the latter group(P<0.05).Conclusions SLE patients should reduce the duration of exposure to sunlight and take effective photoprotective measures.

Key words: Sunlight exposure, Photoprotection, Lupus erythematosus,systemic