Semin Arthritis Rheu:MPO-ANCA阳性伴多血管炎肉芽肿病是ANCA相关血管炎的一个独特亚型

2018-05-14 xiangting MedSci原创

应将MPO-ANCA阳性GPA患者视为AAV的独特亚型。这个亚型的AAV患者肾损伤相对较轻。

过去认为针对蛋白酶3(PR3)的抗中性粒细胞胞浆抗体(ANCA)是伴多血管炎肉芽肿病(GPA)的血清标志物。然而,关于髓过氧化物酶(MPO)-ANCA阳性GPA患者的报道日益增多。这项研究的目的是分析中国MPO-ANCA阳性GPA患者的临床和病理学特征和结局。

研究比较了MPO-ANCA阳性GPA患者、MPO-ANCA阳性显微镜下多血管炎(MPA)患者和蛋白酶3(PR3)-ANCA阳性GPA患者的临床和肾脏组织学数据、肾脏结局、治疗反应、复发和死亡率。

这项研究招募了455名ANCA相关血管炎(AAV)患者。276/455名患者被分类为MPO-ANCA阳性MPA,4/455名患者被分类为PR3-ANCA阳性MPA,124/455名为MPO-ANCA阳性GPA,51/455名为PR3-ANCA阳性GPA。与MPO-ANCA阳性MPA患者相比,MPO-ANCA阳性GPA患者诊断时的BVAS水平较高、肾脏病变较轻。MPO-ANCA阳性MPA患者发展为ESRD的可能性显著高于MPO-ANCA阳性GPA患者。MPO-ANCA阳性GPA患者比MPO-ANCA阳性MPA患者更容易复发。与PR3-ANCA阳性GPA患者相比,MPO-ANCA阳性GPA患者女性的比例更高、诊断时全身症状更少、肾脏病变更轻。

应将MPO-ANCA阳性GPA患者视为AAV的独特亚型。这个亚型的AAV患者肾损伤相对较轻。尽管ANCA特异性在区分AAV上发挥着重要作用,但把这种疾病类型结合起来以分类AAV可能更为合理。

原始出处:

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topicName=多血管炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0b6013824614, createdName=12498bf3m29暂无昵称, createdTime=Wed May 16 02:18:00 CST 2018, time=2018-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1575075, encodeId=7ce215e5075cc, content=<a href='/topic/show?id=6f66121e89e' target=_blank style='color:#2F92EE;'>#MPO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12178, encryptionId=6f66121e89e, topicName=MPO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7b9016060451, createdName=风铃826, createdTime=Wed May 16 02:18:00 CST 2018, time=2018-05-16, status=1, ipAttribution=)]
    2018-05-17 大爰

    学习了谢谢分享!!

    0

  5. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1400797, encodeId=5f911400e97dc, content=<a href='/topic/show?id=0ba9248543' target=_blank style='color:#2F92EE;'>#ANCA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2485, encryptionId=0ba9248543, topicName=ANCA)], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/EE600EF84628E8BB8DF2285885814D26/100, createdBy=116f2265509, createdName=Boyinsh, createdTime=Wed May 16 02:18:00 CST 2018, time=2018-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1545891, encodeId=dd881545891d5, content=<a href='/topic/show?id=f5e743450aa' target=_blank style='color:#2F92EE;'>#多血管炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43450, encryptionId=f5e743450aa, topicName=多血管炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0b6013824614, createdName=12498bf3m29暂无昵称, createdTime=Wed May 16 02:18:00 CST 2018, time=2018-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1575075, encodeId=7ce215e5075cc, content=<a href='/topic/show?id=6f66121e89e' target=_blank style='color:#2F92EE;'>#MPO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12178, encryptionId=6f66121e89e, topicName=MPO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7b9016060451, createdName=风铃826, createdTime=Wed May 16 02:18:00 CST 2018, time=2018-05-16, status=1, ipAttribution=)]
    2018-05-16 zhaojie88
  8. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1400797, encodeId=5f911400e97dc, content=<a href='/topic/show?id=0ba9248543' target=_blank style='color:#2F92EE;'>#ANCA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2485, encryptionId=0ba9248543, topicName=ANCA)], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/101296147/EE600EF84628E8BB8DF2285885814D26/100, createdBy=116f2265509, createdName=Boyinsh, createdTime=Wed May 16 02:18:00 CST 2018, time=2018-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1545891, encodeId=dd881545891d5, content=<a href='/topic/show?id=f5e743450aa' target=_blank style='color:#2F92EE;'>#多血管炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43450, encryptionId=f5e743450aa, topicName=多血管炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0b6013824614, createdName=12498bf3m29暂无昵称, createdTime=Wed May 16 02:18:00 CST 2018, time=2018-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1575075, encodeId=7ce215e5075cc, content=<a href='/topic/show?id=6f66121e89e' target=_blank style='color:#2F92EE;'>#MPO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12178, encryptionId=6f66121e89e, topicName=MPO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7b9016060451, createdName=风铃826, createdTime=Wed May 16 02:18:00 CST 2018, time=2018-05-16, status=1, ipAttribution=)]
    2018-05-16 Boyinsh
  9. 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  10. 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topicName=多血管炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0b6013824614, createdName=12498bf3m29暂无昵称, createdTime=Wed May 16 02:18:00 CST 2018, time=2018-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1575075, encodeId=7ce215e5075cc, content=<a href='/topic/show?id=6f66121e89e' target=_blank style='color:#2F92EE;'>#MPO#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12178, encryptionId=6f66121e89e, topicName=MPO)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7b9016060451, createdName=风铃826, createdTime=Wed May 16 02:18:00 CST 2018, time=2018-05-16, status=1, ipAttribution=)]
    2018-05-16 风铃826

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BMC Nephrol:ANCA相关性血管炎的早期诊断至关重要

摘要 背景:ANCA相关性血管炎急性期之前常有前驱期。本研究目的是分析肾损伤与前驱期长短的相关性。

Clin Exp Rheumatol:抗中性粒细胞胞浆抗体相关血管炎中的低白蛋白血症

肾脏受累的AAV中低白蛋白血症的发病率很高,但并非由重度蛋白尿引起。低白蛋白血症与AAV的高炎症水平和不良预后相关。

Arthritis Rheumatol:ANCA相关性血管炎的流行病学:一项基于人群的20年研究

MPA和EGPA的死亡率,而不是GPA,高于一般人群;MPO-ANCA是生存率差的标志。

J Rheumatol:抗中性粒细胞胞浆抗体相关性血管炎患者的甲状腺疾病患病率升高

AAV患者甲状腺疾病的患病率高于一般人群。而这并不能归因于抗甲状腺药物。

Ann Rheum Dis:利妥昔单抗的个体化定制与固定时间表方案维持ANCA相关性血管炎缓解的比较

利妥昔单抗的个体化定制和固定时间表方案的AAV复发率无显著差异。个体化定制组患者的利妥昔单抗输注次数较少。

BMC Immunol:RF是ANCA相关性血管炎病情活动的炎症标志物

摘要 背景:有些ANCA相关性血管炎(AAV)患者也有类风湿因子(RF)阳性。然而AAV患者中其临床意义未明。本研究的目的是阐明AAV患者中存在RF与患者临床特点的相关性。