在ANCA相关的血管炎中支气管切除症的发病率和特征:系统性审查和元分析
Yu Gu1, Ting Zhang1, Wenyan Zhu1
1Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Beijing, China.
Archives of rheumatology
|November 7, 2024
概括
支气管切除症 (BR) 影响了19%的抗中性粒细胞体抗体 (ANCA) 相关血管炎 (AAV) 患者. 这种共同的并发症具有独特的特征,与特定的AAV表现有关,需要进一步研究其原因.
科学领域:
- 肺部病理学 肺部病理学
- 类风湿病学 类风湿病学
- 内部医学 内部医学
背景情况:
- 反中性细胞质抗体 (ANCA) 相关的血管炎 (AAV) 是一组系统性自身免疫性疾病.
- 支气管病 (BR) 是一种慢性呼吸道疾病,可以与AAV共存,但其患病率和临床意义尚未明确.
研究的目的:
- 确定ANCA相关血管炎 (AAV) 患者中支气管切除症 (BR) 的患病率.
- 探索BR与特定的AAV表现之间的关联.
- 在AAV的背景下描述BR的临床特征.
主要方法:
- 1994年至2022年发表的研究的系统审查和元分析.
- 在PubMed,EMBASE,Web of Science和Cochrane图书馆搜索相关的英语出版物.
- 使用随机效应模型合成流行数据,使用固定效应模型评估关联.
主要成果:
- 在AAV中,BR的综合流行率为19% (95%CI为13-27%).
- 与蛋白酶3 (PR3) -ANCA阳性患者 (13%) 相比,肌氧化酶 (MPO) -ANCA阳性患者 (28%) 的患病率更高.
- BR与女性性别,外围神经病变,MPO-ANCA阳性和微观多炎有关;AAV-BR患者的蛋白尿量较低,BR通常对免疫抑制无反应.
结论:
- 支气管切除症是AAV中常见的并发症,具有明显的临床特征.
- BR和AAV之间的关联表明了超出巧合的潜在联系,尽管潜在的病原体需要进一步调查.
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