J Rheumatol:大血管炎中治疗对疾病活动性影像学、临床和血清学评估的影响

2019-03-28 xiangting MedSci原创

大血管炎(LVV)的疾病活动性传统上通过临床和血清学指标进行评估,而不是血管成像。这项研究结合临床和血清学评估,确定了治疗对18F-氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)血管活动性的影响。在一个观察性队列中对巨细胞动脉炎(GCA)或大动脉炎(TAK)患者每6个月进行一次前瞻性评估。在随诊前至少3个月更改治疗,并将治疗变化分类为增加、减少或不变。在每次就诊时确定影像学(FDG-PET定性分

血管炎(LVV)的疾病活动性传统上通过临床和血清学指标进行评估,而不是血管成像。这项研究结合临床和血清学评估,确定了治疗对18F-氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)血管活动性的影响。

在一个观察性队列中对巨细胞动脉炎(GCA)或大动脉炎(TAK)患者每6个月进行一次前瞻性评估。在随诊前至少3个月更改治疗,并将治疗变化分类为增加、减少或不变。在每次就诊时确定影像学(FDG-PET定性分析)、临床和血清学评估(红细胞沉降率、C-反应蛋白),并在不同间隔间进行比较。

对52名LVV患者(GCA=31;TAK=21)进行了156次随访的连续评估。分别有36、23和32次就诊间隔记录有治疗增加、减少或不变。当治疗增加时,影像、临床和炎症标志物评估的疾病活动性显著降低(p均≤0.01)。当治疗不变时,疾病活动性的全部3种评估在6个月的间隔内保持不变。当治疗减少时,PET活动性显著恶化(p=0.02),但临床和血清学活动性没有显著变化。使用托珠单抗治疗GCA和使用TNF抑制剂治疗TAK使得疾病活动性的影像和临床评估显著改善,但评估很少都变得正常。

除了临床和血清学评估,血管成像也能监测LVV的疾病活动性,应在随机临床试验中作为结果指标进行测试。

原始出处:

Shubhasree Banerjee. Effect of Treatment on Imaging, Clinical, and Serologic Assessments of Disease Activity in Large-Vessel Vasculitis. J Rheumatol. 15 March 2019.

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    2019-08-07 kkunny
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    2019-03-28 champion4ever

    不错

    0

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