Overall Survival Rate In Systemic Lupus Erythematosus In Yunnan Province: An Analysis Of Prognostic Factors In A Cohort Of Patients With Systemic Lupus Erythematosus

[Objective]To investigate the long-term survival rates of the patients with systemic lupus erythematosus in Yunnan province(5 years.10years.15years.20years),and to evaluate the relationship between correlated parameters and patients'prognosis.To analyse the factors that influenced the patient's long-term survival rate.,so that supply the better service for the patients with systemic lupus erythematosus,and provide the theories basis for the improvement of the survival rate.[Methods]A total of 1002 cases of SLE patients at our hospital from January 1 1990. until June 30 2008 were investigated retrospectively,which follow-up by face to face,and a few of them were followed-up by telephone.A overall survival rate can be gained,and the survival curve can be drawed at the same time.According to clinic or report,factors that influencing survival rate including general state,clinical manifestation,complication,therapeutic measure and laboratory examination by analyzed through 291 patient'questionnaire.All data will be analyzed by simple logistic regression analysis,then appraised by multiple factors logistic regression analysis further.The predictors that related with survival rate can be concluded in the end. [Results]1.The overall 5-,10-,15-,and 20-year survival rates of the patients with systemic lupus erythematosus in Yunnan province were 95%,91%,88%,84%,respectivelyo.2.Simple logistic regression analysis revealed:(1).hospitalization many times,long course of disease,relapse(caused by infection),pulmonary hypertention,myocarditis,arrhythmia,pericardial effusion,pleural effusion,alimentary tract hemorrhage,harm of nervous system,harm of hematological system,harm of kidney,epilepsy,psychosis,cerebrovascular accident,mucosal ulcer,fever,higher SLEDAI scores,infection,change of the thyroid gland'function,hypertension,impulsing treatment,higher maintenance dose of excitatory autacoid,loss of lymphocyte,loss of erythrocyte,loss of hemoglobin,thrombocytopenia,erythrosedimenia accelerated,urine protein of 24hour step up,positive of urine protein,positive of urine red blood cell,cylindruria,urea nitrogen step up,urine creatinine step up,uric acid step up,C3 step down,C4 step down and ANA titre step up were the risk factors that influencing survival rate.(2).higher educationg degree,higher individual income,higher family income,having medical insurance,regular follow-up,photoallergy,arthritis and using immunosuppressant were the protective factors of survival rate.3.multiple factors logistic regression analysis revealed seven factors:higher SLEDAI scores,maintenance dose of excitatory autacoid higher than 25mg,arrhythmia,epilepsy,fever,hypertension and higher family income were independent predictors of survival rate..Besides of higher family income was the positive predictor of survival,the existence or step up of others factors were the negative predictors.[Conclusions]1.The overall 5-,10-,15-,and 20-year survival rates of the patients with systemic lupus erythematosus in Yunnan province were 95%,91%,88%,84% respectively,which higher than average's level in our country,and approximate with developed country.Descripting 20-year survival rate of the patients with systemic lupus erythematosus in our country was the longest,and the sample size of single center was the biggest in our country.2.Independent predictors that influencing survival rate of the patients with systemic lupus erythematosus in Yunnan province were higher SLEDAI scores,maintenance dose of excitatory autacoid higher than 25mg,arrhythmia,epilepsy,fever,hypertension and higher family income(p< 0.05).The higher income of family was protective factor for survival rates,and the existence or to heighten of the others factors were the negative factors for survival rate.3.SLE's etiopathogenisis was complicated,and many kinds of factors can influence the disease'occurrence,development and tomover.ALL factors influenced each other,so,clinical doctors should pay attention for them Even though the results of simple logistic regression analysis were not the independent predictors of survival rate.