在血清阴性IgG4-RD患者中揭示显著的临床模式和复发风险因素:十年的回顾性队列研究
Yu Peng1,2,3,4,5, Mu Wang6, Ruijie Sun1,2,3,4
1Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
这项研究揭示了与血清阴性免疫球蛋白G4相关疾病 (IgG4-RD) 的明显临床模式. 开发了一种名目录模型,以预测这些患者的疾病复发.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 临床医学 临床医学
背景情况:
- 免疫球蛋白G4相关疾病 (IgG4-RD) 是一种多系统性纤维炎症疾病.
- 血清阴性IgG4-RD,定义为正常血清IgG4水平,代表了潜在的独特特征的疾病的一个子集.
研究的目的:
- 研究血清阴性IgG4-RD患者独特的临床表现和疾病模式.
- 确定与血清阴性IgG4-RD疾病复发相关的风险因素.
- 开发一种疾病复发的预测模型.
主要方法:
- 对698名以前没有接受过治疗的IgG4-RD患者进行了回顾性分析.
- 根据基线血清IgG4水平分类为子组.
- 血清阴性和血清阳性亚组之间的临床数据和预后的比较.
- COX回归分析用于风险因素识别和名录构造.
主要成果:
- 血清阴性IgG4-RD患者占队列的7.02%,与西方队列相比,在亚洲人群中更为普遍.
- 这些患者表现出较低的血清IgG,eosinophil和IgE水平,降低IgG4-RD响应者指数得分,以及较少的受影响器官.
- 血清阴性IgG4-RD与较高的纤维化模式和特定器官参与的可能性有关.
- 年龄较小,GC单疗,CRP升高和ESR升高被确定为复发风险因素.
- 一个名图模型表明,基线分数>84.65.5的患者复发风险更高.
结论:
- 与血清阳性疾病相比,血清阴性IgG4-RD具有明显的临床特征.
- 一些因素,包括年轻的年龄,GC单疗法和炎症标志物,预测了血清阴性IgG4-RD的复发.
- 经过验证的诺莫格拉姆模型可以帮助预测疾病复发并指导患者管理.
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