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微观多炎患者严重感染和感染相关死亡的危险因素:多中心REVEAL队列研究
Atsushi Manabe1, Keiichiro Kadoba1, Ryosuke Hiwa1
1Department of Rheumatology and Clinical Immunology, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Modern rheumatology
|April 2, 2024
概括
年龄较大,CRP升高和葡萄糖皮质激素 (GC) 缓慢逐渐减少增加了微观多边膜炎 (MPA) 中严重感染 (SI) 和死亡风险. 快速减少GC剂量可能会降低这些风险.
科学领域:
- 类风湿病学 类风湿病学
- 传染性疾病 传染性疾病
- 临床药理学 临床药理学
背景情况:
- 严重感染 (SIs) 和与感染相关的死亡率是显微多炎 (MPA) 患者的重大问题.
- 了解风险因素和治疗对感染结果的影响对于患者管理至关重要.
研究的目的:
- 确定MPA患者中SIs和感染相关死亡率的风险因素.
- 评估葡萄糖皮质体 (GC) 剂量逐渐减少对这些结果的影响.
主要方法:
- 一项多中心,回顾性,观察性研究,使用来自日本REVEAL队列的数据.
- 患者根据SIs或感染相关死亡的发生情况进行分类.
- 通过不同结果组对患者特征的比较.
主要成果:
- 在182名患者中,66名 (36.2%) 患者经历了129次性创伤;27名 (14.8%) 患者因感染而死亡.
- 创伤的独立风险因素包括年龄,高C反应蛋白 (CRP) 和3个月后更高的GC剂量比率.
- 年龄较大与感染相关的死亡有关,24个月后更高的GC剂量比率与死亡率的增加有关.
结论:
- 年龄较大,CRP升高和GC剂量逐渐减缓是MPA中SIs和感染相关死亡的风险因素.
- 建议采用快速的GC剂量逐渐减少策略,以减轻感染风险.
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