J Rheumatol:121例嗜酸性肉芽肿伴多血管炎患者的长期预后

2017-06-09 xiangting MedSci原创

心肌或胃肠道受累患者复发频繁,但这些病情并未反映在死亡率的增加。除了糖皮质激素,使用免疫抑制剂或IVIG可能改善了EGPA患者的预后。

这项研究调查了嗜酸性肉芽肿伴多血管炎(EGPA)复发和预后的危险因素。

在1999年6月至2015年3月,研究人员根据美国风湿病学会标准回顾性入组了121例EGPA患者。频繁复发定义为在初次缓解期后至少每2年发作1次。研究终点是最后一次检查。使用多重logistic回归分析EGPA中复发或生存的危险因素。

胃肠道(GI)受累包括内镜和活组织检查异常(p <0.01)和症状;心肌受累包括1项或多项心脏检查异常和症状(p <0.01); 初始或维持治疗使用免疫抑制剂(p <0.01)或静脉注射免疫球蛋白(IVIG; p <0.01)与频繁复发相关。总体5年,10年和20年生存率分别为91.1%,83.7%和68.6%。EGPA的生存与发病年龄<65岁有关。EGPA发病年龄是生存率的唯一预测指标(p <0.01)。心肌或胃肠道受累并不影响死亡风险。

心肌或胃肠道受累患者复发频繁,但这些病情并未反映在死亡率的增加。除了糖皮质激素,使用免疫抑制剂或IVIG可能改善了EGPA患者的预后。

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