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Arthritis Rheumatol:使用自身抗体和皮肤亚群建立系统性硬化症基于结局的疾病分类

2019-11-25 xiangting MedSci原创

这项研究强调了自身抗体、皮肤亚群和疾病病程在评估SSc发病率和死亡率中的重要性。

这项研究旨在描述系统性硬化症(SSc)患者自身抗体、临床表现与结局之间的关联。作者提出了一个包括抗体和皮肤亚群的新SSc分类。

使用生存分析评估抗体对器官疾病和死亡的影响。

该研究包括1325名受试者。ACA+局限性皮肤SSc组(lc)(n=374)的20年生存率最高(65.3%),而临床明显肺纤维化(csPF8.5%)和硬皮病肾危象的发病率最低(SRC0.3%),心脏SSc发病率低(4.9%),而肺动脉高压(PH)发病率与同期队列平均值相似。

Scl70+lcSSc组(n=138)和弥漫性皮肤SSc组(dc)(n=149)的csPF发病率最高(15年时分别为86.1%和84%)。20年时dcSSc组的生存率最低(32.4%),心脏SSc发病率第二高(12.9%),而lcSSc组的其他并发症很少见,PH发病率最低(6.9%),生存率第二高(61.8%)。

RNA聚合酶+组(n=147)的SRC发病率最高(28.1%)。抗U3RNP+组(n=56)的PH33.8%)和心脏SSc发病率最高(13.2%)。

在有其他自身抗体的lcSSc患者中(n=295),SRC和心脏SSc的风险较低,而其他结局与队列平均水平相似。有其他抗体的DcSSc患者(n=166)预后较差,生存率倒数第二位(33.6%),并经常出现器官并发症。

这项研究强调了自身抗体、皮肤亚群和疾病病程在评估SSc发病率和死亡率中的重要性。该分类有助于疾病监测和临床试验设计。

原始出处:

Svetlana I. Nihtyanova. Using autoantibodies and cutaneous subset to develop outcome‐based disease classification in systemic sclerosis. Arthritis Rheumatol. 04 November 2019.

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    2019-11-27 zhaojie88
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