自身抗体谱、疾病表现和人口特征对系统性红斑狼疮患者存活率的影响:一项比较研究。

IF 3.2 3区 医学 Q2 RHEUMATOLOGY Rheumatology International Pub Date : 2024-11-01 Epub Date: 2024-08-24 DOI:10.1007/s00296-024-05702-5
Marwan H Adwan, Ayman AbuHelal
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引用次数: 0

摘要

研究目的本研究旨在探讨各种临床和免疫学因素(包括疾病表现、自身抗体谱、年龄、性别、病程和系统性红斑狼疮(SLE)家族史)对患者生存结果的影响:方法:对系统性红斑狼疮存活者和非存活者进行比较分析。方法:对系统性红斑狼疮存活者和非存活者进行比较分析,采用逐步逻辑回归分析法评估每个变量对死亡率的影响,从而深入了解它们各自的贡献:研究共纳入了 229 名患者(187 名幸存者和 42 名非幸存者)。幸存者和非幸存者的发病年龄中位数分别为 29 岁和 27.5 岁。与幸存者相比,非幸存者中男性比例更高。亚组分析显示,22 岁以下和 22 岁或以上人群的死亡率存在显著差异,分别为 23.5% 和 7.8%(P = 0.042)。此外,还发现一些特定的临床因素与死亡率增加有关,包括肺动脉高压(PAH)、贫血、血小板减少、肺部疾病和肾脏疾病。相反,某些表现如关节炎和脱发则与死亡风险降低有关。尤其重要的是,PAH 是预测死亡率的最强指标(OR 37.9,P 结论:PAH 是预测死亡率的最重要指标:本研究的发现强调了临床和免疫因素之间复杂的相互作用对系统性红斑狼疮患者生存结果的影响。具体来说,PAH 是预测死亡率的关键因素,这突出了在系统性红斑狼疮患者的管理中进行全面监测、早期检测和及时干预策略以改善长期预后的重要性。
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The influence of autoantibody profile, disease manifestations and demographic features on survival in systemic lupus erythematosus: a comparative study.

Objective: This study aims to investigate the influence of various clinical and immunological factors, including disease manifestations, autoantibody profile, age, gender, disease duration, and family history of systemic lupus erythematosus (SLE), on patient survival outcomes.

Methods: A comparative analysis was conducted between survivors and non-survivors of SLE. Stepwise logistic regression analysis was employed to evaluate the impact of each variable on mortality, allowing for a nuanced understanding of their respective contributions.

Results: A total of 229 patients were included in the study (187 survivors and 42 non-survivors). The median age at disease onset for survivors and non-survivors was 29 and 27.5 years respectively. A higher proportion of men was observed among non-survivors compared to survivors. Subgroup analysis revealed a significant difference in mortality rates between individuals under 22 years and those 22 years or older, with 23.5% and 7.8% mortality rates, respectively (P = 0.042). Moreover, specific clinical factors were found to be associated with increased mortality, including pulmonary arterial hypertension (PAH), anemia, thrombocytopenia, pulmonary disease, and renal disease. Conversely, certain manifestations such as arthritis and alopecia were associated with a reduced risk of mortality. Of particular importance, PAH emerged as the strongest predictor of mortality (OR 37.9, P < 0.012).

Conclusion: The findings of this study underscore the complex interplay between clinical and immunological factors in influencing survival outcomes in SLE patients. Specifically, the identification of PAH as a key predictor of mortality highlights the importance of comprehensive monitoring, early detection, and timely intervention strategies in the management of SLE patients to improve long-term prognosis.

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来源期刊
Rheumatology International
Rheumatology International 医学-风湿病学
CiteScore
7.30
自引率
5.00%
发文量
191
审稿时长
16. months
期刊介绍: RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology. RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
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