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系统性硬化症:1999-2018年芬兰人口发病率的变化

S Kortelainen^1,2, M Käyrä³, S Hurme⁴

¹Centre for Rheumatology and Clinical Immunology, Division of Medicine, Turku University Hospital, Turku, Finland.

Scandinavian journal of rheumatology

|July 13, 2023

概括

1999年至2018年期间,系统性硬化症 (SSc) 的发病率在芬兰显著增加,特别是在有限的SSc病例中,当使用更新的分类标准时. 这种增长凸显了更敏感的诊断指南对疾病发病率的影响.

科学领域:

风湿病学和免疫学
流行病学和公共卫生.
医学诊断和分类医学诊断和分类

背景情况:

系统性硬化症 (SSc) 是一种复杂的自身免疫性疾病,在全球范围内发生率各不相同.
准确的分类标准对于了解疾病的流行率和趋势至关重要.
之前的研究表明,由于不断变化的诊断标准,潜在的诊断不足或错误分类.

研究的目的:

分析芬兰20年系统性硬化 (SSc) 发病率的变化.
使用两个不同的分类标准来比较疾病发病率:美国风湿病学会 (ACR) /欧洲反风湿联盟 (EULAR) 2013年标准和ACR 1980年标准.
确定有助于观察到的发病率趋势的特定SSc亚型.

主要方法:

对于在1999年至2018年期间被诊断患有ICD-10代码M34 (SSc) 的患者的医疗记录的回顾性审查.
用ACR/EULAR 2013标准重新分类患者 (扩散SSc,有限SSc,正弦SSc,早期SSc) 并根据ACR 1980标准进行评估.
研究期间分为五年间隔,以追踪随时间的发生率变化.

主要成果:

在应用ACR/EULAR 2013标准时,在1999-2003年至2014-2018年期间观察到新的SSc诊断的统计学上显著增加 (p=0.0012).
发病率的增加主要归因于有限的SSc诊断的增加.
在使用ACR/EULAR 2013标准的研究期间,每10万居民 (≥16岁) 的平均年发病率从0.9上升到2.8.

结论:

1999年至2018年间,芬兰系统性硬化症的发病率显著增加,特别是使用更敏感的ACR/EULAR 2013分类标准时.
这种观察到的增加主要是由于有限的SSc亚型的增加,这表明病例确定和分类得到了改进.
这些发现强调了更新诊断标准对于准确反映疾病流行病学的重要性.

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