中华皮肤科杂志 ›› 2005, Vol. 38 ›› Issue (1): 14-16.

• 论著 • 上一篇    下一篇

系统性红斑狼疮复发预测的初步研究

吴杰, 李明   

  1. 复旦大学附属中山医院皮肤科, 复旦大学上海医学院皮肤性病学系, 上海200032
  • 收稿日期:2004-01-12 出版日期:2005-01-15 发布日期:2005-01-15
  • 通讯作者: 李明,E-mail:liming@zshospital.net E-mail:liming@zshospital.net

Preliminary Study on Flare-Prediction in Patients with Systemic Lupus Erythematosus

WU Jie, LI Ming   

  1. Department of Dermatovenereology, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Received:2004-01-12 Online:2005-01-15 Published:2005-01-15

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摘要： 目的 探讨常用实验室检查和症状以及血清可溶性白介素2受体(sIL-2R)在预测系统性红斑狼疮(SLE)复发中的价值。方法 采用SLE疾病活动指数(SLEDAI)作为病情判定标准,对106例SLE门诊患者进行前瞻性随访,要求患者复诊间隔不超过3个月并随访了6～18个月,每次随访时均按照研究方案记录其实验室检查、临床症状和治疗措施,根据各指标在复发前出现异常的频率和时间综合考察其预测复发的价值。结果 106例患者中有67例的病情处于稳定期,符合进行前瞻性观察病情复发的要求,共观察到29例患者的31次复发,复发率为0.44/人·年。综合预测能力最高的指标是抗ds-DNA抗体,其次为补体系统、sIL-2R、血沉、血常规、尿常规、疲乏感、黏膜溃疡、新发皮疹和脱发。C3比C4和CH50能更好地预测SLE复发。结论 SLE的复发是可以预测的。早期干预有助于患者避免病情复发。

关键词: 红斑狼疮,系统性, 复发, 预测

Abstract: Objective To study the value of routine laboratory examinations, symptoms and soluble IL-2 receptor (sIL-2R) in the flare-prediction on systemic lupus erythematosus(SLE). Methods A prospective study was performed in 106 outpatients with SLE and the patients' conditions were assessed according to Systemic Lupus Erythematosus Disease Activity Index(SLEDAI). Patients were asked to visit at no longer than 3-month interval. All patients were followed-up for 6 to 18 months. At each visit, laboratory examinations, symptoms, disease activity, as well as the changes in the treatment were recorded according to the protocol. The values of these parameters in flare-prediction were comprehensively assessed based on their frequency and time respectively when they became abnormal before the disease flare. Results Among the 106 patients, the disease activity of 67 cases were in remission and satisfied the prospective study criteria of the SLE flare. Thirty-one flares in 29 patients were observed. The frequency of flare was 0.44/patient/year. Comprehensively the most valuable predictor of those parameters was anti-dsDNA antibody, followed by complement components, sIL-2R, erythrocyte sedimentation rate(ESR), complete blood count, urine analysis, fatigue, mucous membrane ulceration, new rashes and alopecia. C3 was a better predictor for SLE flares than that of C4 and CH50. Conclusions The flares of SLE could be predicted. Early intervention will help to prevent patients from flare.

Key words: Lupus erythematosus, systemic, Recurrence, Prediction