Clin Exp Rheumatol:早期血清学阴性关节炎会发展成类风湿性关节炎吗?

2018-07-24 xiangting MedSci原创

经过10年的随访,重新分类显示血清学阴性RA的诊断存在显著异质性。

这项研究调查了血清学阴性关节炎患者的10年临床过程,重点是在适用时对诊断重新分类。

1997年至2005年在Jyvaskyla风湿病中心共有1030例患者被分类为早期RA,其中包括435个血清学阴性病例,对这些患者进行为期十年的随访。回顾性收集10年访视或死亡前(以先发生者为准)随访和病例报告的临床数据,并在适用时对病例重新分类进行审查。数据使用描述性统计。

在435例血清阴性病例中(69%为女性,基线平均年龄为59岁),13例(13/435 [3%])可以重新分类为血清学阳性或侵蚀性RA:4例转为血清学阳性(2例为ACPA,2例为RF [> 2x参考水平]),9例出现典型的RA侵蚀。重新分类显示68例(16%)为风湿性多肌痛、46例(11%)为银屑病关节炎、45例(10%)为骨性关节炎、38例(8.7%)为脊柱关节炎、15例(3.4%)为潜在反应性关节炎、10例(2.3%)为痛风、17例(3.9%)为假性痛风、6例(1.4%)为副肿瘤性关节炎、6例(1.4%)为幼年关节炎、2例(0.5%)为血色病、3例(0.7%)为强直性脊柱炎、2例(0.5%)为巨细胞动脉炎、8例为杂项诊断。其他140例患者(32%)无法在任何明确诊断中重新分类,其中有短暂性关节炎(n = 41)、血清学阴性脊柱关节炎(n = 47)的特征,而49例仍为非特异性。

经过10年的随访,重新分类显示血清学阴性RA的诊断存在显著异质性。因此,不应将血清学阴性关节炎作为一种疾病进行研究。

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    2018-07-24 小树熊

    学习了,谢谢

    0