系统性硬化症患者的健康评估问卷的长期过程
Sophie Ie Liem1, Sytske Anne Bergstra1, Jacopo Ciaffi2
1Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Journal of scleroderma and related disorders
|September 25, 2023
概括
系统性硬化症患者的健康评估问卷-残疾指数平均保持稳定. 然而,三分之一的人经历恶化,在使用免疫抑制剂或患有胃肠道问题的患者中不太常见.
科学领域:
- 类风湿病学 类风湿病学
- 临床结果研究研究
背景情况:
- 健康评估问卷-残疾指数 (HAQ-DI) 是系统性硬化症 (SSc) 功能残疾的关键指标.
- 对SSc患者HAQ-DI变化的纵向数据有限,需要对其长期轨迹进行进一步调查.
研究的目的:
- 在SSc患者队列中分析HAQ-DI的长期过程.
- 为了确定与HAQ-DI随着时间的推移恶化或改善相关的基线特征.
主要方法:
- 系统性硬化症患者 (n=517) 来自莱顿综合护理系统性硬化症队列每年进行评估.
- 评估了硬化硬化症健康评估问卷-残疾指数 (HAQ-DI),使用0.22.2的最小临床重要差异对课程进行了分类.
- 使用线性混合模型和后勤回归分析来评估HAQ-DI趋势和与基线因素的关联.
主要成果:
- 平均HAQ-DI每年略有增加,为0.019,这表明集团水平的整体稳定性.
- 在整个随访期间,35%的患者经历了临床上有意义的恶化,42%的情况保持稳定,23%的情况有所改善.
- 65岁以上的患者或那些死亡/无法参加后续检查的患者的平均HAQ-DI较差.
- 免疫抑制剂的基线使用 (OR=0.5) 和胃肠道干扰的存在 (OR=0.6) 与HAQ-DI恶化的可能性降低有关.
结论:
- 虽然SSc患者的平均HAQ-DI是稳定的,但个体轨迹有很大差异,其中三分之一显示恶化.
- 免疫抑制剂的使用和在基线的胃肠道干扰是防止SScHAQ-DI恶化的保护因素.
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