Is it the season of worry recurrence again? In the scorching summer, doctors issue disease management guidelines for lupus patients
2024-06-24
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that is more common in women of childbearing age between 15 and 45 years old, and affects millions of people in China. Summer is approaching, with rising temperatures and increased UV intensity, many lupus patients are once again in the season of worrying about disease recurrence. How should lupus patients take comprehensive protection in summer to prevent recurrence? What symptoms should be vigilant about the possibility of recurrence? Medical experts have issued key points for summer disease management in lupus patients. The organ damage caused by recurrence affects long-term survival. In recent years, although the 10-year survival rate of lupus patients has increased to 89%, the long-term survival rate of 25-30 years has shown a cliff like decline of only 30%, which is related to irreversible organ damage. As an immune system disease that affects multiple systems throughout the body, systemic lupus erythematosus can cause damage to multiple organs and tissues such as the kidneys, cardiovascular system, lungs, digestive system, blood system, blood vessels, and eyes, and significantly increase the risk of death for patients. Many patients still lack sufficient awareness of the importance of organ protection and have not established a long-term standardized management concept. They often reduce their dosage, stop taking medication, or fail to seek medical attention on time once their condition is stable due to concerns about traditional therapies such as hormones. Professor Zeng Xiaofeng, Director of the National Clinical Medical Research Center for Dermatology and Immunology, emphasized that the treatment of lupus not only focuses on controlling the condition as soon as possible in the short term, but also on long-term organ protection, that is, balancing the "immediate" and "long-term" aspects. With the deepening understanding of lupus disease in clinical practice and the emergence of innovative drugs, many authoritative guidelines at home and abroad have updated their treatment concepts for lupus, calling for attention to the long-term prognosis of patients and emphasizing the importance of organ protection in improving their long-term quality of life. The kidney is the most easily affected organ in SLE. About 40% -60% of SLE patients have lupus nephritis at the beginning of the disease, and 10-20% of lupus nephritis patients can progress to end-stage renal disease within 5 years of diagnosis, which is an important cause of death in SLE patients. Professor Yang Xiangdong, a member of the National Standing Committee of the Nephrology Branch of the Chinese Medical Association, said, "For patients with lupus nephritis, regular follow-up, timely treatment, and standardized treatment are indispensable. This is because lupus nephritis has a recurrent condition and complex pathological types. Regular follow-up helps medical students judge the progress of the disease, evaluate the degree of kidney damage, and formulate reasonable plans in a timely manner to reduce the risk of recurrence. In addition, protecting kidney function is the key to the treatment of lupus nephritis, which requires patients to follow medical advice and use medication in a standardized manner. The emergence of biological agents can help patients improve the remission rate, reduce hormone use, reduce adverse drug reactions, and protect kidney function. Reasonable sun protection and lifestyle management are important to prevent recurrence." Summer has strong ultraviolet rays, research has shown that, Ultraviolet radiation is not only one of the important causes of lupus, but also a significant factor in the recurrence and worsening of the condition. Up to 60% of lupus patients are stimulated or worsened by sunlight exposure. Professor Zeng Xiaofeng suggests that "preventing ultraviolet radiation is the most important protective measure for lupus patients, especially those who have had rashes before. It is important to take reasonable sun protection measures. In summer, the intensity of ultraviolet radiation increases, and if possible, it is best not to go out during the strongest noon sunlight. If it is necessary to go out, sun protection should be done, and sunscreen, umbrellas, or protective clothing that can prevent ultraviolet radiation can be used. It is worth noting that if patients suddenly experience prolonged fever, redness, hair loss, arthritis, joint swelling, and pain, they should go to the hospital for a follow-up examination. Professor Yang Xiangdong also reminds that for lupus nephritis patients, with high summer temperatures, they should also drink water scientifically and reasonably: To avoid drinking too much water and increasing the burden on the kidneys, as well as to avoid insufficient renal perfusion due to excessive water restriction, Promote the deterioration of damaged kidney function. In terms of diet, it is also recommended to prioritize a light and nutritious diet. Lupus is a disease that requires long-term treatment. Professor Zeng Xiaofeng said, "In recent years, we have been actively promoting the key work of standardized diagnosis and treatment projects for systemic lupus erythematosus, committed to improving the uniformity of lupus diagnosis and treatment. Last year, the" Principles for the Construction and Management of Standardized Diagnosis and Treatment Centers for Systemic Lupus erythematosus "were officially introduced, with the hope of improving the national level of standardized diagnosis and treatment for lupus and regional medical service capabilities through the implementation of these principles and the construction of diagnosis and treatment centers. Professor Zeng Xiaofeng also added that the convenience of medical services is particularly important for patients' long-term benefits and chronic disease management.". Medical services should be patient-centered and provide continuous and convenient services to patients. For example, if biological agents require intravenous infusion, it is recommended to include them in the scope of daytime outpatient treatment to address the urgent needs of patients with systemic lupus erythematosus and maximize clinical benefits by utilizing existing medical resources. (Lai Xin She)
Edit：Xiong Dafei Responsible editor：Li Xiang
Source：WHB
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