Ann Rheum Dis:加拿大安大略省系统性红斑狼疮的全因、病因和年龄特异性标化死亡率

2019-04-20 xiangting MedSci原创

随着时间的推移,全因和病因特异性SMR明显下降,这可能反映了SLE和某些合并症治疗的进步。

过去50年间,系统性红斑狼疮(SLE)的生存率有显著提高。这项研究目的是评估加拿大安大略省狼疮患者的全因、病因特异性和年龄特异性标化死亡率(SMRs)的演变。

1971年至2013年间,多伦多狼疮诊所对1732名患者进行了随访。从死亡证明、尸检报告、医院记录或家庭医生的记录中查找死亡原因。死亡原因被分类为动脉粥样硬化、感染性疾病、恶性肿瘤、活动性狼疮及其他。为了计算SMR(间接标准化方法),使用来自加拿大安大略省一般人群的数据(加拿大统计局)。

249名患者(205名女性)死亡(感染24.5%,动脉粥样硬化15.7%,活动性狼疮13.3%,恶性肿瘤9.6%);平均年龄为53.2±16.6岁,平均病程为15.2±11.7年。从20世纪70年代(13.5,95%CI 8.6-18.5)到最近几年(2.2,95%CI 1.4-3.1),全因SMR明显下降。随着时间推移,观察到动脉粥样硬化、感染和恶性肿瘤有类似趋势。与年龄>40岁的人相比(SMR=3.1,95%CI 2.6-3.6),年轻患者(19-39岁)的全因年龄特异性SMR特别高(SMR = 12.4,95%CI 9.7-15.1)。年轻患者的病因特异性SMR也较高,尤其是感染和恶性肿瘤。

随着时间的推移,全因和病因特异性SMR明显下降,这可能反映了SLE和某些合并症治疗的进步。对于年轻患者(<40岁),全因和病因特异性SMR特别高。

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    2019-04-22 zhouqu_8

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