系统性红斑狼疮患者的抑郁情绪与疾病因素的关联性研究进展

系统性红斑狼疮(systemic lupus erythematosus,SLE)是一种累及多系统、多器官并有多种自身抗体出现的自身免疫性疾病.多数SLE患者存在抑郁情绪.抑郁与患者的疾病活动、累积损害、激素用量以及抗核糖体P蛋白抗体(anti-ribosomal P protein antibodies,anti-P)之间的相关性研究结果各不相同;抑郁与患者的睡眠质量、疲乏症状、纤维肌痛和偏头痛、认知功能、焦虑以及治疗依从性均有关联.     

纤维蛋白原/白蛋白比值与系统性红斑狼疮肾脏损害及疾病活动度的相关性

目的  探讨系统性红斑狼疮(systemic lupus erythematosus, SLE)初诊患者纤维蛋白原/白蛋白比值(fibrinogen-albumin ratio, FAR)与肾脏损害及疾病活动度的相关性。方法  以159例健康人群作为对照组,回顾性分析156例SLE初诊患者的相关临床数据。结果  SLE患者的FAR明显高于对照组(Z=-10.390, P < 0.001),SLE患者中重度活动组FAR明显高于轻度活动组(Z=-4.703, P < 0.001),狼疮肾炎组FAR明显高于非狼疮肾炎组(Z=-6.312, P < 0.001);SLE患者的FAR和补体C3(r=-0.249, P=0.002)、血清总蛋白(r=-0.474, P < 0.001)呈负相关,和血沉(r=0.383, P < 0.001)、C-反应蛋白(r=0.293, P < 0.001)、血尿素氮(r=0.220, P=0.006)、血尿酸(r=0.296, P < 0.001)、血肌酐(r=0.180, P=0.025)、24 h尿蛋白(r=0.588, P < 0.001)及SLE疾病活动度指数(r=0.430, P < 0.001)呈正相关;多因素logistic回归分析模型分析显示FAR是SLE疾病中重度活动(OR=1.010, 95% CI: 1.003~1.018, P=0.008)、肾脏损害(OR=1.020, 95% CI: 1.009~1.032, P < 0.001)的独立危险因素。根据受试者工作特征曲线,FAR用于诊断SLE、SLE疾病中重度活动及肾脏损害的曲线下面积分别为0.84(95% CI: 0.79~0.88)、0.72(95% CI: 0.64~0.80)及0.80(95% CI: 0.72~0.87)。结论  FAR与SLE患者疾病活动度、肾脏损害相关,对评估SLE疾病活动度及肾脏损害具有一定的临床意义。     

Systemic lupus erythematosus in Portugal: Diagnosis and disease awareness from 1970 to 2001

A survey of systemic lupus erythematosus patients was carried out in Portugal. The length of time from disease appearance to diagnosis remained unchanged over the 1970–2001 study period, while awareness of the disease increased considerably in the population in the mid-1990s, apparently as a result of an awareness campaign conducted by the national lupus support group. The data are compared to results from similar studies worldwide.     

慢性病患者生命质量测定量表体系——系统性红斑狼疮量表的研制及信度与效度分析

目的研制慢性病患者生命质量测定量表体系中的系统性红斑狼疮量表QLICD—SLE（V2．0）,并对它的信度、效度进行分析。方法通过对143名系统性红斑狼疮病人的测量来考评该量表的信度和效度。结果系统性红斑狼疮量表QLICD—SLE（V2．0）,由29个条目的共性模块（QLmD—GM）和19个条目的特异模块构成。各领域及总量表的Cronbach＇s α系数、分半信度和重测信度分别为：生理功能领域：0．74,0．83,0．74;心理功能领域：0．87,0．91,0．81;社会功能领域：0．75,0．79,0．72;特异模块领域：0．84,0．86,0．88;总量表：0．69,0．96,0．67。量表各条目和本领域得分的相关系数除GPS10、SLE14、SLE17这3个条目外都在0．60以上,且明显大于各条目和其他领域的相关系数。特异模块、共性模块因子分析结构均与理论构想一致。量表各领域与效标各领域显著相关。结论QLICD—SLE（V2．0）具有较好的信度、效度和临床可行性。     

Assessment of quality of life in children,adolescents, and adults with celiac disease through specific questionnaires: Review

ObjectivesThe gluten-free diet (GFD) is a lifelong treatment for celiac patients which affects the quality of their life (QoL). This was evaluated by generic methods. Over time, specific instruments for celiac disease (CD) have been developed. The objective of this review is to identify the different CD-specific instruments that have estimated QoL in celiac patients, study their psychometric properties, and highlight the factors influencing the final scores.Materials and methodsAn advanced database search (PubMed, Web of science, etc.) was launched in order to identify articles that evaluated QoL in children, adolescents, and adults with celiac disease. The items and subscales of each questionnaire were determined with the comparison of psychometric properties (Internal consistency, Reproductibility, Acceptance, Floor effect, Ceiling effect, Convergent validity, Construct validity and Discriminative validity).ResultsEighteen specific instruments have been identified. The assessment of QoL in celiac patients by these specific instruments allowed detecting the influence of specific characteristics related to CD on QoL. The developed and validated instruments showed acceptable psychometric properties in different countries. The obtained results showed that the QoL related to CD is reduced. However, monitoring GFD helps improving these scores.ConclusionCD-specific instruments are increasing considerably. They contain relevant items that can properly assess the QoL in patients with celiac disease.