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J Rheumatol:系统性硬化症—系统性红斑狼疮重叠综合征的流行病学和生存率

2018-08-11 xiangting MedSci原创

SSc-SLE患者诊断时较年轻、PAH更常见、SSc的皮肤表现较少。

系统性硬化症(SSc)可能与系统性红斑狼疮(SLE)存在重叠。目前关于SSc-SLE重叠的流行病学、临床特征和生存率知之甚少。这项研究评估了SSc-SLE重叠的患病率和SSc特征的差异,并比较了无SLE的SSc生存率。

这是一项队列研究,纳入符合美国风湿病学会(ACR)/欧洲抗风湿联盟SSc分类标准和/或SLE ACR标准的受试者。主要结局是从诊断到全因死亡率的时间。使用Kaplan-Meier和Cox比例风险模型评估生存率。

共确定了1252名受试者(SSc:n=1166,SSc-SLE:n=86),其中SSc-SLE的患病率为6.8%。SSc-SLE患者诊断时更年轻(37.9岁vs 47.9岁,p<0.001),东亚人(5.5% vs 20%)或南亚人更常见(5.1% vs  12%),有狼疮抗凝物(6%vs 0.3%,p<0.001)、抗心磷脂抗体(6%vs 0.9%,p<0.001)和肺动脉高压(PAH; 52%vs 31%,p<0.001)。SSc-SLE患者较少发生钙化(13%vs 27%,p=0.007)、毛细血管扩张(49%vs 75%,p<0.001)和弥漫性亚型(12%vs 35%,p<0.001)。肾危象(7%vs 7%)、间质性肺病(ILD; 41%vs 34%)和肢端溃疡(38%vs 32%)的发生率无显著差异。SSc-SLE患者的中位生存时间更长(26.1 vs 22.4年),但这没有统计学意义(log-rank p=0.06)。女性和弥漫性亚型减弱了组间的生存率差异(HR 1.07,95%CI 0.67-1.67)。

SSc-SLE患者诊断时较年轻、PAH更常见、SSc的皮肤表现较少。应对患者进行ILD、肾危象和肢端溃疡监测。


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  5. 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    2018-08-13 xugumin
  6. 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    2018-08-13 zhouqu_8
  8. 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replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/ajNVdqHZLLDicHg2ldsSNmib46PmdzpO7CQEmPjuULp1v45zPWwMYhrnXgvl3OtmUCZSQfgITWn96X9moL94nUGA/0, createdBy=28072041016, createdName=131****1460, createdTime=Sun Aug 12 08:00:05 CST 2018, time=2018-08-12, status=1, ipAttribution=)]
    2018-08-12 131****1460

    学习了受益匪浅

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