症状严重程度和葡萄糖皮质类药物剂量在患有多肌痛风湿症和肥胖症的患者
Marco A Cimmino1, Cynthia S Crowson2, Bhaskar Dasgupta3
1M.A. Cimmino, MD, Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, Genova, Italy; marcoamedeo.cimmino@gmail.com.
肥胖与多发性肌痛性风湿症 (PMR) 患者的症状严重程度增加和更高的普德尼松使用有关. 这表明,在PMR管理中,BMI影响疼痛感知比炎症更大.
科学领域:
- 类风湿病学 类风湿病学
- 临床医学 临床医学
- 炎症性疾病 炎症性疾病
背景情况:
- 多发性肌痛风湿症 (PMR) 是老年人常见的炎症状况,导致疼痛和硬.
- 肥胖对类风湿性疾病活动的影响已经确立,但其在PMR中的具体作用尚未完全理解.
研究的目的:
- 调查高体重指数 (BMI) 与多肌痛性风湿症的严重程度和治疗结果之间的关联.
- 为了确定肥胖是否影响PMR患者的症状感知或疾病活动.
主要方法:
- 在6个月内对83名近期出现的PMR患者进行了后期分析.
- 收集的数据包括临床检查,实验室测试,腰带超声波,mHAQ,SF-36,VAS分数和普得尼松剂量.
- 患者根据BMI进行了分层,以比较结果.
主要成果:
- 肥胖的PMR患者在基线报告了显著增加的肩膀疼痛,全身疼痛,疲劳和较低的生活质量得分.
- 尽管先尼松的初始剂量相似,但肥胖患者在6个月后需要更高的平均每日剂量,并且更有可能超过标准方案.
- 临床,实验室和超声波发现在肥胖和非肥胖群体之间是可比的,这表明主观的疼痛差异.
结论:
- 肥胖严重影响多发性肌痛症的症状严重程度和预尼松的需求.
- 这些发现表明,改变疼痛感知,而不是增加炎症,可能解释了在肥胖的PMR患者中观察到的差异.
- 医疗保健提供者在评估PMR症状和确定适当的普得尼松治疗策略时,应考虑患者的BMI.
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