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患有ANCA相关血管炎的患者的功能长期结局
Beatriz Sachez-Alamo1,2, Laura Moi3, Ingeborg Bajema4
1Department of Clinical Sciences Lund, Division of Nephrology, Lund University, Sweden.
概括
对抗中性粒细胞质抗体相关血管炎 (AAV) 的早期诊断对于结局至关重要. 组织学评分系统预测的存活率,移植为符合条件的患者提供了有利的结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
背景情况:
- 脏干扰是抗中性粒细胞质抗体相关血管炎 (AAV) 的常见并发症.
- 在AAV的预后受到损伤程度的显著影响.
- 这项研究研究了长期结局,风险因素,以及AAV患者组织学分类的预测性能.
研究的目的:
- 评估抗中性粒细胞质抗体相关血管炎 (AAV) 患者的长期结局.
- 确定与损伤和AAV进展相关的风险因素.
- 为了比较三个组织学分类在AAV中预测脏结果的有效性.
主要方法:
- 从七个随机对照试验 (1995-2012) 中分析了848名新诊断的AAV患者.
- 通过主要调查人员的问卷收集的后续数据.
- 在214名接受脏活检的患者中,对三种评分系统 (伯登,脏风险评分,梅奥诊所评分) 的评估.
主要成果:
- 末期病 (ESKD) 的累积发病率在5年后为17%,在10年后为22%.
- 患有ESKD的患者的生存率显著降低 (HR 2.8,P < .001).
- 组织学得分表明正常的质细胞和严重的质结核病是脏存活的关键预测因素 (P < .001,P = .001). 风险评分显示预测准确度中等 (AUC 0.79).
结论:
- 早期诊断AAV对于改善患者预后至关重要.
- 即使是轻微的脏干扰也会影响长期的结果.
- 脏移植为符合条件的AAV患者提供了有利的生存率,需要脏替代疗法 (KRT). 组织学评分系统是独立的预后因素.
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