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Haematologica：血管性血友病患者关节出血的长期影响如何？

2017-06-03 xing.T MedSci原创

血管性血友病关节出血长期影响
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总之，40%的血管性血友病患者关节出血后发生关节病，并且与疼痛、影像学异常、功能限制以及较少的社会参与相关。

血管性血友病（VWD）患者关节出血后可能发展为关节病。但是其患病率和严重程度的信息十分有限。近日，血液病领域权威杂志Haematologica上发表了一篇研究文章，研究人员旨在评估VWD患者关节病的发生及严重程度，并评估其对日常生活的影响。

在荷兰血友病研究中，研究人员将证实有或无关节内出血的血友病患者匹配年龄、性别和凝血因子VIII水平或血管性假血友病因子活性进行巢式病例对照研究。评估指标包括血友病关节健康评分（0-124分）、Pettersson评分（X线每关节0-13）、血友病活动列表评分（0-100分）、关节疼痛（视觉模拟量表0-10）和影响参与和自主性问卷（0-20）。关节病被定义为血友病关节健康评分≥10或1≤Pettersson评分＜3个关节。

研究人员纳入了48例证实为关节出血患者（病例组）和48例对照者；男性占60%，平均年龄为46岁（范围为18-80岁），正位血管性假血友病因子活性为5 vs. 8IU/dL，并且VIII因子为24 vs. 36IU/dL。40%的病例发生关节病，而对照组为10%（P＜0.01）。与对照组相比，这些病例表现出更多的功能限制（中位数血友病活动评分：88 vs. 100，P＜0.01）。在病例组中，关节病与关节疼痛以及较少的社会参与度相关（视觉模拟量表> 3:13/19 vs. 3/28，P＜0.01，参与问卷的平均分数为6.1 vs. 0.9，P＜0.01）。

总之，40%的血管性血友病患者关节出血后发生关节病，并且与疼痛、影像学异常、功能限制以及较少的社会参与相关。

原始出处：

Karin P.M. van Galen, et al. Long-Term Impact Of Joint Bleeds In Von Willebrand Disease: A Nested Case-Control Study. Haematologica. 2017. http://www.haematologica.org/content/early/2017/06/01/haematol.2017.168617

本文系梅斯医学（MedSci）原创编译整理，转载需授权！


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  1. 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content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun Jun 04 00:26:23 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2018-03-02 yangeasy

    #关节出血#

    0

  2. 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    2017-10-25 changfy

    #HAE#

    0

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content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun Jun 04 00:26:23 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2018-03-28 limedical1974

    #长期影响#

    0

  4. 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createdTime=Mon Jun 05 08:37:04 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206607, encodeId=bd0620660e38, content=很不错，值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Sun Jun 04 23:43:30 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206439, encodeId=16d42064392a, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Sun Jun 04 15:21:15 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206166, encodeId=e083206166a5, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun Jun 04 00:26:23 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2018-04-25 仁心济世

    #血管性#

    0

  5. 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content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun Jun 04 00:26:23 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2017-06-07 1e10eabem79(暂无匿称)

    很好的，一篇文章，有价值

    0

  6. 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content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun Jun 04 00:26:23 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2017-06-05 fengyi812

    #EMA#

    0

  7. 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createdTime=Mon Jun 05 08:37:04 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206607, encodeId=bd0620660e38, content=很不错，值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Sun Jun 04 23:43:30 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206439, encodeId=16d42064392a, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Sun Jun 04 15:21:15 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206166, encodeId=e083206166a5, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun Jun 04 00:26:23 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2017-06-05 龙胆草

    学习谢谢分享

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=2033399, encodeId=6e75203339917, content=<a href='/topic/show?id=79553009414' target=_blank style='color:#2F92EE;'>#关节出血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30094, encryptionId=79553009414, topicName=关节出血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e12a151, createdName=yangeasy, createdTime=Fri Mar 02 11:15:00 CST 2018, time=2018-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008259, encodeId=7e2720082598a, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, createdName=changfy, createdTime=Wed Oct 25 13:15:00 CST 2017, time=2017-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2053260, encodeId=a82d205326083, content=<a href='/topic/show?id=6d7796998e0' target=_blank style='color:#2F92EE;'>#长期影响#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=96998, encryptionId=6d7796998e0, topicName=长期影响)], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/cc81592b507031e3cfd8d4c57911d98b/62c22832a9474aea1ca90ca058aebc03.jpg, createdBy=bed5446, createdName=limedical1974, createdTime=Wed Mar 28 12:15:00 CST 2018, time=2018-03-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1812333, encodeId=dc7e18123332f, content=<a href='/topic/show?id=9ff9896405e' target=_blank style='color:#2F92EE;'>#血管性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89640, encryptionId=9ff9896405e, topicName=血管性)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Wed Apr 25 02:15:00 CST 2018, time=2018-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=207550, encodeId=056720e55018, content=很好的，一篇文章，有价值, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5gJeAA33pg8XSpMyoXQLg4TTWfCC26g4ibkFFUdQVBtofBwAITTWib8S4f1bKDLaYsKVz2KtVfhLQJoia5mISjlibk/0, createdBy=28331949612, createdName=1e10eabem79(暂无匿称), createdTime=Wed Jun 07 07:12:45 CST 2017, time=2017-06-07, status=1, ipAttribution=), 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createdTime=Mon Jun 05 08:37:04 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206607, encodeId=bd0620660e38, content=很不错，值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Sun Jun 04 23:43:30 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206439, encodeId=16d42064392a, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Sun Jun 04 15:21:15 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206166, encodeId=e083206166a5, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun Jun 04 00:26:23 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2017-06-04 131****2916

    很不错，值得推荐

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2033399, encodeId=6e75203339917, content=<a href='/topic/show?id=79553009414' target=_blank style='color:#2F92EE;'>#关节出血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30094, encryptionId=79553009414, topicName=关节出血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e12a151, createdName=yangeasy, createdTime=Fri Mar 02 11:15:00 CST 2018, time=2018-03-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2008259, encodeId=7e2720082598a, content=<a href='/topic/show?id=1066844469' target=_blank style='color:#2F92EE;'>#HAE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=8444, encryptionId=1066844469, topicName=HAE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=32d177, 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createdTime=Mon Jun 05 08:37:04 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206607, encodeId=bd0620660e38, content=很不错，值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Sun Jun 04 23:43:30 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206439, encodeId=16d42064392a, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Sun Jun 04 15:21:15 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206166, encodeId=e083206166a5, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun Jun 04 00:26:23 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2017-06-04 dhzzm

    学习了分享了

    0

  10. 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likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89640, encryptionId=9ff9896405e, topicName=血管性)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Wed Apr 25 02:15:00 CST 2018, time=2018-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=207550, encodeId=056720e55018, content=很好的，一篇文章，有价值, beContent=null, objectType=article, channel=null, level=null, likeNumber=123, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo5gJeAA33pg8XSpMyoXQLg4TTWfCC26g4ibkFFUdQVBtofBwAITTWib8S4f1bKDLaYsKVz2KtVfhLQJoia5mISjlibk/0, createdBy=28331949612, createdName=1e10eabem79(暂无匿称), createdTime=Wed Jun 07 07:12:45 CST 2017, time=2017-06-07, status=1, ipAttribution=), 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createdTime=Mon Jun 05 08:37:04 CST 2017, time=2017-06-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206607, encodeId=bd0620660e38, content=很不错，值得推荐, beContent=null, objectType=article, channel=null, level=null, likeNumber=126, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Sun Jun 04 23:43:30 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206439, encodeId=16d42064392a, content=学习了分享了, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=387d1660055, createdName=dhzzm, createdTime=Sun Jun 04 15:21:15 CST 2017, time=2017-06-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=206166, encodeId=e083206166a5, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun Jun 04 00:26:23 CST 2017, time=2017-06-04, status=1, ipAttribution=)]
    2017-06-04 tanxingdoctor

    学习啦谢谢分享

    0

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