摘要 目的：确定SLE患者达到无激素性缓解的频率，并分析这些患者的疾病特征。 方法：回顾性分析289例[男20例, 女269例, 年龄(45.8±15.3)岁, 病程(15.0±12.2)年，满足1997 ACR SLE分类标准并一直在医院随访]患者的临床资料。无激素性缓解的定义是：连续3个月未用激素治疗且无病情活动。了解和分析激素的使用情况、SLEDAI－2000及临床特点。

结果：所有SLE患者目前激素的使用率为79.2%,终生使用激素的患者比例为96.9%，46例患者(15.9%) 达无激素性缓解，5例患者(1.7%) 停用激素后病情复发，9 (3.1%)例患者从未用过激素。达到无激素性缓解的患者年龄更大、肾脏受累更少。其它因素包括性别、病程、SLE分类标准满足的项目数，开始激素治疗时的病情活动度、激素的初始量及免疫抑制剂的使用均未达统计学差异。

结论：虽然无激素性缓解的频率较低，但老年和未并发肾炎与可停用激素相关。SLE患者停用激素缓解可能是一个可以实现的目标。

附原文： ABSTRACT Objectives: To determine the frequency of steroid free remission and to define disease characteristics of lupus patients achieving steroid-free remission.Methods: We retrospectively reviewed clinical charts of 289 patients (male 20, female 269, age 45.8±15.3 y.o., disease duration 15.0±12.2 years) who met 1997 ACR SLE Classification Criteria followed in our university hospital. Steroid free remission was defined as a 3-month consecutive period of no disease activity and without corticosteroid treatment. Corticosteroid use, SLEDAI-2K and clinical characteristics were examined. Results: Frequency of current corticosteroid users of all the SLE patients was 79.2%, and that of life time users was 96.9%. Forty six patients (15.9%) achieved steroid free remission. Five patients (1.7%) experienced disease flare after cessation of corticosteroid, 9 (3.1%) patients had never received corticosteroid. Patients in steroid free remission were older and renal involvement was less frequent than the other patients. Other factors including gender, disease duration, number of positive items in the SLE classification criteria, disease activity (SLEDAI-2K) at the initiation of steroid therapy, initial dose of steroid and use of immunosuppressant did not reach significant difference. Conclusion: Although the frequency of steroid free remission was low, older age and absence of nephritis were associated with discontinuation of corticosteroids. Steroid free remission might be a realistic goal in some patients with lupus.

Disclosure of Interest: None declared

引自：A. Suda, S. Ohno, H. Ideguchi, et al. Frequency and characteristics of lupus patients achieving steroid-free remission. Ann Rheum Dis 2010;69(Suppl3):571