《中国系统性红斑狼疮诊疗指南(2025版)》解读

Interpretation on the Chinese Guidelines for the Diagnosis and Treatment of Systemic Lupus Erythematosus (2025 edition)

  • 摘要: 系统性红斑狼疮(systemic lupus erythematosus,SLE)是一种高度异质性的系统性自身免疫性疾病,可累及多器官,具有反复发作及慢性进展特征。随着诊断与治疗技术的不断发展,SLE的管理策略正从“疾病控制”逐步向“长期缓解与器官保护”转变。结合国内外最新研究证据及中国人群特征,国家皮肤与免疫疾病临床医学研究中心和中国系统性红斑狼疮研究协作组(Chinese SLE Treatment and Research Group,CSTAR)牵头制定了最新版《中国系统性红斑狼疮诊疗指南(2025版)》。新版指南以“达标治疗”为核心理念,提出以临床缓解与低疾病活动状态为主要治疗目标,优化了糖皮质激素、免疫抑制剂、生物制剂及新兴治疗手段的应用策略,新增了狼疮性肾炎、多器官受累、抗磷脂综合征等重点问题的个体化管理建议,并首次纳入SLE患者疫苗接种的循证推荐意见。该指南充分融合本土大样本队列研究与真实世界数据,内容更精准、可操作性更强,对我国SLE的诊疗与长期管理具有重要指导价值。

     

    Abstract: Systemic lupus erythematosus (SLE) is a highly heterogeneous systemic autoimmune disease characterized by multi-organ involvement, recurrent flares, and chronic progression. With advances in diagnostics and therapeutics, SLE management is shifting from disease control toward long-term remission and organ protection. Incorporating recent global evidence and characteristics of the Chinese population, the National Clinical Research Center for Dermatologic and Immunologic Diseases and the Chinese SLE Treatment and Research Group (CSTAR) have developed the Chinese guidelines for the diagnosis and treatment of systemic lupus erythematosus (2025 edition). Centered on a treat-to-target strategy, the guidelines prioritize clinical remission and low disease activity as primary goals, optimizing the use of glucocorticoids, immunosuppressants, biologics, and novel therapies. Key updates include individualized management recommendations for lupus nephritis, multi-organ involvement, and antiphospholipid syndrome, alongside first-ever evidence-based recommendations on vaccination in SLE patients. By integrating large-scale domestic cohort studies and real-world data, this edition provides more precise and actionable guidance, offering significant value for standardizing and improving SLE diagnosis, treatment, and long-term management in China.

     

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