CAJ | 학술논문

目的对育龄期男女SLE患者临床特点进行研究.方法由各参研单位根据统一方式收集病历资料,总结江苏省1999-2009年间住院1 956例SLE患者的临床资料,比较育龄期男性和女性患者的临床表现、免疫学指标、疾病活动度、死亡等指标.统计学处理组间的计数资料比较采用x2检验,非正态分布的定量资料比较采用秩和检验.结果 1 839例SLE患者纳入研究范围,其中男性117例,女性1 722例,通过对照研究,男性患者发病年龄[(32±12)岁]、住院年龄[(36±12)岁]晚于女性[(30±10)岁和(33±10)岁](x2=-2.151,x2=-2.177,P＜0.05),男性患者更易出现浆膜炎、肝脾淋巴结肿大、血清ALT及血清肌酐异常(P＜0.05),而女性患者更易出现关节炎、贫血、抗dsDNA抗体阳性(P＜0.05);男性患者病死率13.68％(16/117)高于女性患者7.38％(127/1 722)(x2=6.064,P＜0.05),死亡原因分析表明,感染是男女SLE患者死亡的首位原因,其次女性因肾脏累及、肾功能不全死亡,而男性因神经系统累及死亡.结论育龄期男女SLE患者临床特点有所不同,男性更易出现肝肾功能损害,而女性更易出现关节累及、贫血.男性患者病死率高,预后差.
목적 대육령기남녀SLE환자림상특점진행연구.방법 유각삼연단위근거통일방식수집병력자료,총결강소성1999-2009년간주원1 956례SLE환자적림상자료,비교육령기남성화녀성환자적림상표현、면역학지표、질병활동도、사망등지표.통계학처리조간적계수자료비교채용x2검험,비정태분포적정량자료비교채용질화검험.결과 1 839례SLE환자납입연구범위,기중남성117례,녀성1 722례,통과대조연구,남성환자발병년령[(32±12)세]、주원년령[(36±12)세]만우녀성[(30±10)세화(33±10)세](x2=-2.151,x2=-2.177,P＜0.05),남성환자경역출현장막염、간비림파결종대、혈청ALT급혈청기항이상(P＜0.05),이녀성환자경역출현관절염、빈혈、항dsDNA항체양성(P＜0.05);남성환자병사솔13.68％(16/117)고우녀성환자7.38％(127/1 722)(x2=6.064,P＜0.05),사망원인분석표명,감염시남녀SLE환자사망적수위원인,기차녀성인신장루급、신공능불전사망,이남성인신경계통루급사망.결론 육령기남녀SLE환자림상특점유소불동,남성경역출현간신공능손해,이녀성경역출현관절루급、빈혈.남성환자병사솔고,예후차.
Objective To analyze the clinical characteristics of male and female patients with systemic lupus erythematosus (SLE) in child-bearing age.Methods Data was collected by the same methods in the past ten years in fifteen hospitals in Jiangsu Province and then it was summarized for retrospective analysis.The difference in clinical manifestations,laboratory features and outcome were analyzed between male and female patients and then the data was analyzed by chi-square test and Wilcoxon rank sum test.Results One thousand eight hundred and thirty nine SLE patients (117 male and 1 722 female patients) were investigated.In the case control study,male patients had an older onset age [(32±12) years old] and hospitalized age [(36±12) years old] than female patients [(30±10) and (33±10) years old] (x2=-2.151,x2 =-2.171,P ＜0.05).Male patients had more serositis,general lymphadenopathy/hepatosplenomegaly and fatality rate [male:13.68％(16/117),female:7.38％(127/1 722),x2=6.064,P＜0.05] while female patients had more arthritis and anemia (P＜0.05).Male patients had higher frequency of liver function abnormalities and higher serum creatinine (Scr) while female patients had higher anti-dsDNA positivity rate (P＜0.05).Among the 135 deceased patients,severe infection was the main cause of death in male and female patients,followed by kidney damage in female patients and nervous system damage in male patients.Conclusion Our study suggests that there are major clinical differences between male and female patients with SLE in child bearing age.Male patients have much more severe organ damage than female patients and male patients has higher rate of fatality rate and worse prognostic than female patients.