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When it comes to systemic lupus erythematosus (SLE), everyone knows that it is a disease related to the human immune system, but how serious is this disease and what are the symptoms? Is it true that the more severe the symptoms, the more severe the disease? The answers to these questions may not be clear even to some old patients
.
"The big wolf is called the little wolf bite"
Disease activity cannot be judged solely by symptoms
SLE is an autoimmune disease that can cause damage to multiple organs and tissues such as kidneys, blood system, nervous system, digestive system, cardiovascular, lung, skin, and eyes, and failure to receive timely and effective treatment will significantly increase the risk of
death.
One of the core mechanisms of SLE pathogenesis is the massive activation of B lymphocytes in the body, producing a large number of autoantibodies, which lead to tissue damage
.
Antibodies are like the human body "police", when harmful substances, that is, "bad people" enter the body, the immune system, that is, the "police station" will send a large number of police, identify "bad people", and eliminate bad people
in time.
If there is a problem with the immune system, the police sent will attack their normal tissues and organs, and "autoantibodies" are the "bad cops"
.
When SLE is active, the number of "bad cops" in the body increases, and the damage to various organs in the body is more serious
.
Professor Zhu Jian, deputy director of the Department of Rheumatology of the PLA General Hospital Chinese People's Liberation Army, said: "Whether systemic lupus erythematosus is in the active phase needs to be determined comprehensively through the patient's recent symptoms and physical examination data, rather than relying only on the patient's subjective feelings
.
We often use 'big wolf bites little wolf' to describe the impact of
SLE on patients.
Many patients feel obvious when the disease is not too serious, and have symptoms such as low-grade fever, rash, and joint pain, just like a wolf barking; When the disease is more serious, such as nephritis, blood system damage, the patient does not feel much, only through the examination found that the indicators have seriously exceeded the standard, just like the wolf directly bites, silent, very
harmful.
”
"It's not a big problem, wait and see"
Disease activity is increasing while waiting
Some patients have rashes, joint pain and other symptoms, always hold the "problem is not big, wait and see" mentality, delay treatment, the main reason for this mentality is the fear that the amount of hormones will be added and produce side effects
.
However, these patients not only did not wait for the disease to remission, but also became more active due to delayed treatment
.
Generally, when we find that patients have erythema and joint pain, we will give patients a more comprehensive examination, including kidney function
.
An important lesion site of systemic lupus erythematosus is small blood vessels, and the kidneys are rich in capillaries, so the kidneys are common organs affected by this disease
.
In order to prevent patients from relying on dialysis or kidney transplantation to survive, corticosteroids and immunosuppressants should be used in time to control the patient's kidney lesions as soon as possible when disease activity is detected early
.
If it cannot be controlled for a period of time, such patients are very likely to further progress to kidney disease in the future
.
Therefore, great emphasis is placed on early and timely identification of these patients and timely and active treatment
.
”
Some patients are very happy that their glucocorticoids can be reduced, or even stop taking the drug, and when they feel unwell or have signs of recurrence, they are very reluctant to admit that the disease has begun to move again, and psychologically resist treatment
.
"Many patients with a long course of disease do not pay attention to regular visits and assessment of disease activity when small doses of
hormones are maintained or even self-discontinued with various drugs.
Some patients come to the clinic only after they have lower limb edema, when lupus nephritis is already very serious; A small number of patients even have epilepsy, that is, lupus encephalopathy before coming to the doctor
.
Such a repeated disease will not only accept more drugs and spend more money, but also patients and their families will suffer more
.
In fact, when the disease is active, timely detection and active treatment can still control the disease and reduce the drug dose, but you must listen to the doctor, do not reduce the drug without authorization, stop the drug, so as to avoid unnecessary fluctuations
in the condition.
Zhu Jian reminded
.
"Early treatment, steady descending"
Reducing disease activity requires standardized treatment
Timely detection of disease activity and initiation of aggressive treatment at an early stage are critical
to reducing disease activity.
"If patients have rashes, joint pain and other symptoms, see a doctor as soon as possible; If there are no symptoms, it is also necessary to adhere to basic examinations such as blood routine, urine routine, liver and kidney function, immunoglobulin and complement every three months, so as to timely detect the recurrence of the disease and adjust treatment
in time.
”
In the selection of treatment options, Zhu Jian introduced: "At present, the treatment drugs of SLE include glucocorticoids, immune preparations, antimalarial drugs and biological agents that have just been approved for marketing in China this year
.
Biologics can inhibit the excessive proliferation and differentiation of B cells, that is, reduce the number of 'bad cops', thereby reducing disease activity and treating SLE
.
”
The choice of effective drugs, but also pay attention to the standardized treatment plan, in order to reduce the degree of disease activity, so that the disease stays in the remission period, at this time need to emphasize a "stable" word, to follow the standardized treatment plan
.
"Some patients are afraid of the side effects of hormones and quickly reduce the amount of hormones on their own, but will increase the risk of disease recurrence, this misunderstanding is still very common
.
As a chronic disease, SLE should be managed
for a long time.
Only by standardizing treatment, controlling the condition in a state of relatively minimal damage to each organ, and controlling the dose of drugs in the range of the least side effects to patients, patients can be in remission for a long time and maintain a good functional state
.
”