在患有全身性红血性狼的患者中,与早期氧化诱导的视网膜毒性相关的因素
Olga Araújo1, Halbert Hernández-Negrín1, Ricardo P Casaroli-Marano2
1Department of Autoimmune Diseases, Member of the European Reference Centres (ERN) Re-CONNET and RITA, Reference Centre for Systemic Autoimmune Diseases, Vasculitis and Autoinflammatory Diseases of the Catalan and Spanish Health Systems, Hospital Clínic de Barcelona. Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Villarroel 170, 08036, Barcelona, Catalonia, Spain.
概括
在全身性红斑狼 (SLE) 患者中,早期氧化 (HCQ) 视网膜毒性与狼抗凝剂阳性和高胆固醇血症有关. 这些因素可能会增加HCQ诱导的眼睛损伤的风险,无论治疗的持续时间或剂量.
科学领域:
- 眼科医生 眼科 眼科
- 类风湿病学 类风湿病学
- 临床药理学 临床药理学
背景情况:
- 氧化 (HCQ) 是系统性红斑狼 (SLE) 的基石疗法.
- 治疗HCQ可以导致不可逆转的视网膜毒性,影响患者的视力.
- 识别HCQ视网膜毒性的早期指标对于患者管理至关重要.
研究的目的:
- 在SLE患者中确定与早期氧化诱导的视网膜毒性相关的因素.
- 在20年的时间内分析人口,临床,实验室和治疗数据.
- 了解HCQ治疗前5年内黄斑毒性风险因素.
主要方法:
- 追溯分析1998年至2017年间诊断的345名SLE患者,至少进行1年的随访.
- 从电子医疗记录中收集的数据,包括人口统计,临床,实验室和治疗细节.
- 早期视网膜毒性定义为HCQ开始后5年内黄斑毒性;通过视野测试,脑后镜检查和SD-OCT诊断.
主要成果:
- 在337名接受HCQ治疗的患者中,38名 (11.3%) 患有视网膜毒性;10名 (3%) 患有早期毒性.
- 早期的毒性发生在平均治疗持续时间为3.3年,累计剂量为241g.
- 早期毒性的独立风险因素包括狼抗凝剂阳性 (OR 4.2) 和高胆固醇血症 (OR 5.6).
结论:
- 狼抗凝剂阳性和高胆固醇血症是SLE患者早期HCQ诱导的视网膜毒性潜在风险因素.
- 这些风险因素似乎与HCQ剂量或治疗持续时间无关.
- 这些发现强调了监测这些特定患者亚组早期视网膜损伤迹象的重要性.
相关概念视频
01:17Factors Affecting Renal Clearance: Renal Impairment
91
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
91
01:31Factors Affecting Renal Clearance: Drug's Physicochemical Properties and Plasma Levels
217
Renal clearance of a drug is influenced by various factors, including its physicochemical properties and plasma levels. These factors play a significant role in determining how efficiently the kidneys eliminate a drug.
One important factor is the drug's molecular size. The kidneys readily excrete smaller molecules below 300 Daltons (Da). On the other hand, molecules weighing between 300 and 500 Da are excreted through both urine and bile. Larger molecules above 500 Da tend to be excreted...
One important factor is the drug's molecular size. The kidneys readily excrete smaller molecules below 300 Daltons (Da). On the other hand, molecules weighing between 300 and 500 Da are excreted through both urine and bile. Larger molecules above 500 Da tend to be excreted...
217