青春期前至青春期狼:临床,实验室和结局概况的年龄相关变化
Lujayn Akbar1, Majd S Khader2, Rawan Elshaer2
1King Fahd Hospital of the University, Al-Khobar, Saudi Arabia.
Lupus
|July 11, 2025
概括
儿童开始的全身性红斑狼 (cSLE) 呈现出与年龄相关的变化. 青春期前发病的cSLE的死亡率明显较高,这凸显了在这个脆弱群体中早期诊断和干预的需要.
科学领域:
- 儿科风湿病学 儿科风湿病学
- 自免疫性疾病 自免疫性疾病
- 系统性红斑性狼 红斑性狼 系统性狼
背景情况:
- 儿童开始的全身性红斑狼 (cSLE) 是一种复杂的自身免疫性疾病,根据年龄表现不同.
- 目前关于与年龄相关的cSLE变异的研究受限于回顾性设计和单一国家队列,导致不一致的发现.
- 了解特定年龄的差异对于优化cSLE的诊断和管理至关重要.
研究的目的:
- 系统地调查儿童发作系统性红斑狼 (cSLE) 的与年龄相关的变化,跨不同的子组:青春期前,青春期前,青春期前和青少年发作.
- 为了在这些cSLE年龄组中比较临床表现,疾病活性,损伤和结果.
主要方法:
- 按照PRISMA指南进行了系统审查,搜索PubMed,Cochrane图书馆和Web of Science,查找2000年1月至2025年2月期间发表的研究.
- 符合条件的研究包括那些检查18岁之前诊断的cSLE年龄相关变异的研究,数据分为前青春期,周青春期和青少年发病组.
- 使用NHLBI标准评估研究质量,数据提取和分析由多位审稿人进行.
主要成果:
- 在16313项选研究中,13项符合纳入标准,包括3920例cSLE病例:11.8%是青春期前,49.6%是青春期前,38.6%是青春期开始.
- 女性与男性的比例在青少年发病组中最高 (p = .002). 肌肉骨参与随着年龄的增长而增加,而神经精神症状和发烧则减少.
- 死亡率在青春期前组 (16.5%) 与青春期发病组 (2.9%) 相比显著更高 (p = .014),尽管各组的疾病活动和损伤相似.
结论:
- 这一系统性审查强调了儿童发病的系统性红斑狼 (cSLE) 中与年龄相关的显著差异,特别是在死亡率方面.
- 青春期前发病的cSLE与较高的死亡率有关,这凸显了迅速诊断和积极的早期干预的急需.
- 对cSLE特定年龄管理策略的进一步研究是有必要的,以改善所有年龄组的长期结果.
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