同时的自身免疫和多发性硬化症的风险使残疾恶化
Stefanie Binzer1, Jan Hillert2, Ali Manouchehrinia2
1Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden; Kolding Hospital, Department of Neurology, Kolding, Denmark.
Multiple sclerosis and related disorders
|May 18, 2024
概括
像1型糖尿病 (T1D),克罗恩病 (CD) 和性结肠炎 (UC) 这样的自身免疫疾病显著增加了多发性硬化症 (MS) 患者残疾恶化的风险. 提高对并发症的警对于优化长期MS结果至关重要.
科学领域:
- 神经学 神经学
- 免疫学 免疫学 免疫学
- 流行病学 流行病学
背景情况:
- 多发性硬化症 (MS) 是一种慢性神经系统疾病.
- 同时发生的自身免疫性疾病对MS残疾进展的影响尚不清楚.
- 这项研究调查了1型糖尿病 (T1D),克罗恩病 (CD) 和性结肠炎 (UC) 对MS残疾恶化的影响.
研究的目的:
- 评估同时发生的自身免疫性疾病 (T1D,CD,UC) 与多发性硬化症患者残疾进展之间的关联.
- 量化MS患者在患有这些并发症时达到特定扩展残疾状态量表 (EDSS) 里程碑 (3.0,4.0,6.0) 的风险.
主要方法:
- 利用来自瑞典多发性硬化病登记处和瑞典国家患者登记处 (2004-2019) 的全国数据.
- 采用卡普兰-梅尔分析来估计到残疾里程碑的时间.
- 应用调整后的考克斯比例危险回归模型来确定与并发症相关的风险.
主要成果:
- 在8972名多发性硬化患者中,分析了T1D (1.0%),UC (0.8%) 和CD (0.9%).
- 患有T1D的MS患者的EDSS 6.0 (HR=2.21) 的风险更高.
- 患有CD的MS患者患EDSS 3.0 (HR=2.30) 和4.0 (HR=1.59) 的风险增加.
- 患有UC的MS患者患EDSS 3.0的风险增加 (HR=1.57).
- 整体并发症显著增加了所有残疾终点的风险 (HR=1.23-1.62).
结论:
- 同时发生的自身免疫性疾病 (T1D,CD,UC) 与多发性硬化症中残疾进展的风险显著增加有关.
- 这些并发症的存在需要提高临床注意力,以优化患者的治疗结果.
- 进一步研究这些关联背后的机制是有必要的.
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