从血清阳性关节痛到类风湿性关节炎的进展:来自Reuma-Check计划中的大型队列的一年预测因素
Rodrigo Garcia-Salinas1, Nataly MeJia-Maggi1, Felicia Almada1
1Rheumatology Unit, Hospital Italiano de La Plata - Universidad Nacional de La Plata, 51 street, 1725, La Plata 1900, Argentina.
Seminars in arthritis and rheumatism
|November 23, 2025
概括
血清阳性关节痛 (SA) 影响了12%的早期关节炎患者. 抗素蛋白抗体 (ACPA) 阳性强烈预测一年内进展为类风湿性关节炎 (RA).
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 流行病学 流行病学
背景情况:
- 血清阳性关节痛 (SA) 在患有类风湿因子 (RF) 和/或抗素蛋白抗体 (ACPA) 的个体中呈现为没有突炎的关节疼痛.
- SA被认为是类风湿性关节炎 (RA) 的临床前阶段,早期风险识别对于及时干预至关重要.
研究的目的:
- 为了确定SA在大量早期关节炎队列中的流行率.
- 为了比较SA患者和RA患者的基线特征.
- 确定一年内从SA发展为RA的预测因素.
主要方法:
- 在早期风湿病学评估的Reuma-Check计划中的前性研究.
- 标准化的临床,血清学和成像评估确定了SA和RA患者.
- 在12个月的随访期间,逻辑回归分析了RA发展的独立预测因素.
主要成果:
- 沙氏肺炎的患病率为12% (208/1730),而RA的患病率为13% (225/1730).
- 与RA患者相比,SA患者表现出较少的疼痛/胀关节,较少的炎症标志物和较少的超声波功率多普勒阳性.
- 一年后,21%的SA患者进展为RA,14%发展为其他免疫媒介疾病,65%保持稳定. ACPA阳性是RA进展的唯一独立预测因素 (OR:7.7).
结论:
- 在Reuma-Check队列中,ACPA阳性是患有血清阳性关节炎的个体中进展为类风湿性关节炎的最重要的预测因素.
- 早期识别SA患者的ACPA阳性可能允许有针对性的监测和干预策略,以防止RA的发展.
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