患有巨细胞动脉炎的低基线C反应蛋白患者的患病率,特征和结果
Samuel Pichon1, Vincent Koether2, Amélie Leurs2,3
1Service de Médecine Interne, Centre de référence des Maladies Auto- Immunes et Auto-inflammatoires Systémiques rares de l'Adulte du Nord, Méditerranée et Guadeloupe (CeRAINOM), Univ. Lille, CHU Lille, Nord-Ouest, Lille, F-59000, France. samuel.pichon0@gmail.com.
Arthritis research & therapy
|July 31, 2025
概括
巨细胞动脉炎 (GCA) 可能发生在低C反应蛋白 (CRP) 的情况下. 低CRP GCA患者表现出更多的眼睛和四肢问题,但复发率与高CRP患者相似.
科学领域:
- 类风湿病学 类风湿病学
- 血管炎症 血管炎症
- 诊断标记物 诊断标记物
背景情况:
- 像C反应蛋白 (CRP) 这样的炎症标志物升高对于诊断和监测巨细胞动脉炎 (GCA) 至关重要.
- 然而,GCA患者的一个子组呈现出低基线CRP水平,这给诊断带来了挑战.
研究的目的:
- 调查低基线CRP (<10 mg/L) 的GCA患者的患病率,临床特征和结果.
- 将这些特征与高CRP (≥10 mg/L) 升高的GCA患者进行比较.
主要方法:
- 一项回顾性观察性研究分析了380名在2000年至2023年期间被诊断为GCA的患者.
- 患者被分为低CRP (<10毫克/升) 和高CRP (≥10毫克/升) 的两组.
- 基线特征,临床表现,实验室结果,成像发现和结果进行了比较.
主要成果:
- 7.6%的GCA患者的基线CRP低.
- 低CRP组的发烧较低,但眼部干扰 (前面缺血性视神经病变) 和四肢的比例较高.
- 在77%的低CRP组中观察到血纤维素的升高 (>4 g/L),表明正在进行的炎症.
结论:
- 低CRP的巨细胞动脉炎并不罕见,并且与明显的临床特征有关,包括眼睛和外周血管表现的增加.
- 低CRP GCA患者中纤维素水平升高表明活跃的炎症,需要临床警.
- 由于严重并发症的风险,即使CRP<10 mg/L,也应该考虑使用GCA.
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