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在患有硬质皮质症的患者中进行移植
Lior Bear1, Nancy Agmon Levine2, Ronen Ghinea3
1Department of Surgery, Sheba Medical Center, Tel Hashomer, Israel, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
The Israel Medical Association journal : IMAJ
|October 14, 2024
概括
系统性硬化症 (SSc) 可以导致脏问题,包括硬化的脏危机 (SRC). 虽然ACE抑制剂降低了SRC死亡率,但末期脏疾病仍然是SSc患者的重要关注点.
科学领域:
- 类风湿病学 类风湿病学
- 腎臟病學 (nephrology) 是一種醫學.
- 自免疫性疾病 自免疫性疾病
背景情况:
- 脏干扰在全身性硬化症 (SSc) 中很常见,影响约50%的患者.
- 结核病性危机 (SRC) 是一种严重的并发症,影响大约20%的SSc患者,特别是那些患有扩散皮肤SSc (dcSSc) 和抗RNA聚合酶III抗体的人.
- 引入血管激素转化酶抑制剂 (ACE-i) 已经降低了SRC的流行率和死亡率.
研究的目的:
- 审查系统性硬化症中脏参与的流行病学和结果.
- 突出结核病危机 (SRC) 和其管理的影响.
- 讨论SSc患者的晚期病 (ESRD) 和替代疗法 (RRT) 的进展情况.
主要方法:
- 文献综述专注于系统性硬化症中的脏表现.
- 对有关硬化性病危机 (SRC) 患病率,死亡率和治疗的数据的分析.
- 检查末期病 (ESRD) 和SSc.中的移植率.
主要成果:
- 在引入ACE抑制剂后,SRC死亡率从78%降至30-36%.
- 尽管结果有所改善,但进展到末期病 (ESRD),需要置换疗法 (RRT) 是常见的.
- 患有ESRD的SSc患者的脏移植率仍然相对较低 (4-17%).
结论:
- 系统性硬化症经常涉及脏,SRC是一个主要问题.
- 虽然ACE抑制剂改善了SRC结果,但长期功能和RRT仍然是SSc患者的关键问题.
- 需要进一步的研究,以优化SSc患者的护理和移植策略.
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