Arthritis Rheumatol:血浆血管生物标志物在系统性硬化症中的有效性

2020-03-30 xiangting MedSci原创

这些数据表明,参与血管生成的分子反映了血管的扰动,入组时生物标志物的升高可以对患者进行危险分层。

肺动脉高压(PH)和缺血性指端病变(DL)是硬皮病的两种血管结局,在横断面研究中其与血管生成的生物标志物异常相关。这些生物标志物的临床用途目前尚不明确,部分原因是由于缺乏纵向测量数据。

这是一项前瞻性队列研究,纳入300例系统性硬化症患者(SSc),并至少随访5年,这些患者入组时没有PH和/或活动性DL的证据。在多个时间点获取肝细胞生长因子(HGF)、可溶性Flt-1、可溶性内皮糖蛋白、内皮抑素和血小板源性生长因子(PlGF)的水平,并评估其预测出现PH/DL的能力。

46例患者(15%)出现PH,69例患者(23%)出现DL。在时间-事件分析中,发现入组时测量的3种生物标志物与出现PH显著相关:HGF(HR 1.99,95%CI 1.24-3.17,p=0.004)、sFlt1(HR 3.04,95%CI 1.29-7.14,p=0.011)和PlGF(HR 2.74,95%CI 1.32-5.69,p=0.007)。随着接近PH诊断的时间减少,任何生物标志物水平均没有相应升高。将每个连续性血管生物标志物转换为二元变量后,观察到入组时升高生物标志物的数量与发生PH的风险之间存在剂量反应关系:入组时升高的生物标志物每增加1个,出现PH的风险增加78%(HR 1.78,95%CI 1.2-2.6,p=0.004)。

这些数据表明,参与血管生成的分子反映了血管的扰动,入组时生物标志物的升高可以对患者进行危险分层。

原始出处:

Christopher A. Mecoli. The Utility of Plasma Vascular Biomarkers in Systemic Sclerosis: A Prospective Longitudinal Analysis. Arthritis Rheumatol. 21 March 2020.

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    2020-04-01 zhaojie88
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