在多发性肌痛性风湿症中亚临床血管炎的患病率,特征和结果:回顾性队列研究
Lien Moreel1,2, Lennert Boeckxstaens3,4, Albrecht Betrains1,2
1Department of General Internal Medicine, UZ Leuven, Leuven, Belgium.
Rheumatology (Oxford, England)
|March 28, 2024
概括
亚临床血管炎影响9%的多肌痛类风湿患者,主要涉及大血管. 虽然需要更高的初始葡萄糖皮质激素剂量,但复发率和治疗持续时间等结果仍然相似.
科学领域:
- 类风湿病学 类风湿病学
- 内部医学 内部医学
- 核医学是一种核医学.
背景情况:
- 多发性肌痛风湿症 (PMR) 经常与亚临床血管炎有关.
- 以前的元分析表明,PMR患者的亚临床血管炎的患病率为22-23%.
- 在PMR中亚临床血管炎的特征和结果需要进一步调查.
研究的目的:
- 为了确定PMR患者中亚临床血管炎的患病率.
- 在这个队列中描述亚临床血管炎的特征.
- 评估PMR患者的临床结果,包括复发率和治疗持续时间,包括患有和没有亚临床血管炎的患者.
主要方法:
- 连续诊断患有巨细胞动脉炎/PMR谱系疾病,并呈现单独的PMR症状的患者的回顾性分析.
- 纳入标准包括在2003年至2020年期间接受-18-氧化葡萄糖正子发射断层扫描 (FDG PET) 成像,并进行至少6个月的随访.
- 亚临床血管炎被定义为在任何血管中2级或更高的FDG吸收.
主要成果:
- 在包括的337名患者中,31名 (9%) 患有亚临床血管炎.
- 大多数患有亚临床血管炎的患者患有孤立的大血管血管炎 (58%) 或结合骨和大血管血管炎 (23%).
- 患有亚临床血管炎的患者在诊断后的头12个月内接受了较高的初始和随访葡萄糖皮质体 (GC) 剂量,但在GC治疗持续时间,复发率或停止GC治疗的能力方面没有显著差异.
结论:
- 亚临床血管炎在9%的PMR患者中被发现,倾向于大血管参与.
- 尽管最初的GC剂量较高,但亚临床血管炎并没有显著影响复发率或GC治疗的总持续时间.
- 需要进一步的前性研究来阐明PMR患者的最佳管理策略,包括亚临床血管炎.
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