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Semin Arthritis Rheu:伴眼部受累巨细胞动脉炎患者的特征和结局

2020-03-22 xiangting MedSci原创

该研究观察到四分之一的GCA患者有眼部受累。AION仍与最差的视力预后相关,IV甲泼尼龙冲击治疗并不能降低失明的风险。

这项研究旨在描述诊断时患有巨细胞动脉炎(GCA)相关眼部受累患者的特征和预后。

这是一项纳入409例连续性GCA患者的回顾性单中心队列研究,其中104例在GCA诊断时存在视觉症状,研究人员将他们与104例年龄和性别匹配的无眼部受累的对照进行比较。每种视觉症状都与眼科诊断有关,而眼科诊断由眼科医生进行重新评估。

与对照组相比,伴有视觉症状的患者发烧(p=0.0006)和风湿性多肌痛较少见(p=0.02),急性期反应物水平较低(p=0.004)。在GCA诊断之前,患者描述了四种视觉症状:视力模糊(占患者的60%)、一过性黑矇(占18%)、复视(占13%)和永久性视力丧失(占9%)。47例患者(45%)出现前部缺血性视神经病变(AION),其次是15例患者(15%)出现了视网膜中央动脉阻塞(CRAO)。2例患者两种情况同时存在。有无视觉症状患者间的糖皮质激素的延迟治疗没有差异(p=0.06)。在60例有初始AION和/或CRAO患者中,尽管45例(75%)接受了甲泼尼龙静脉(IV)冲击治疗,仍有39例(65%)持续失明或严重视力受损。尽管已经开始治疗,仍有4%的视觉症状患者出现新的缺血事件(均为AION)。

该研究观察到四分之一的GCA患者有眼部受累。AION仍与最差的视力预后相关,IV甲泼尼龙冲击治疗并不能降低失明的风险。

原始出处:

Anaël Dumont. Characteristics and outcomes of patients with ophthalmologic involvement in giant-cell arteritis: A case-control study. Semin Arthritis Rheu. April 2020.

 

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    2021-02-02 xsm927
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    2020-06-21 huiwelcome
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    2020-03-24 zhaojie88
  6. [GetPortalCommentsPageByObjectIdResponse(id=1972709, encodeId=bed919e270983, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Sun Jul 19 23:25:45 CST 2020, time=2020-07-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1683209, encodeId=a9e31683209e6, content=<a href='/topic/show?id=60f03325e28' target=_blank style='color:#2F92EE;'>#动脉炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33257, encryptionId=60f03325e28, topicName=动脉炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d22a27947071, createdName=xsm927, createdTime=Tue Feb 02 13:25:45 CST 2021, time=2021-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1800711, encodeId=27611800e1182, content=<a href='/topic/show?id=7f57e29184f' target=_blank style='color:#2F92EE;'>#眼部受累#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72918, encryptionId=7f57e29184f, topicName=眼部受累)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ac59108, createdName=hxj0117, createdTime=Wed Dec 23 02:25:45 CST 2020, time=2020-12-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1776094, encodeId=4b151e7609464, content=<a href='/topic/show?id=508ae2913d6' target=_blank style='color:#2F92EE;'>#眼部#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72913, encryptionId=508ae2913d6, topicName=眼部)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=126338864246, createdName=huiwelcome, createdTime=Sun Jun 21 17:25:45 CST 2020, time=2020-06-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357443, encodeId=947d135e443d3, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Tue Mar 24 03:25:45 CST 2020, time=2020-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502275, encodeId=f73815022e567, content=<a href='/topic/show?id=021d4821096' target=_blank style='color:#2F92EE;'>#巨细胞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=48210, encryptionId=021d4821096, topicName=巨细胞)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=11759518880, createdName=wwzzly, createdTime=Tue Mar 24 03:25:45 CST 2020, time=2020-03-24, status=1, ipAttribution=)]
    2020-03-24 wwzzly

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