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Medicine：系统性红斑狼疮患者外周动脉闭塞疾病发生增加

2015-11-29 phylis 译 MedSci原创

系统性红斑狼疮外周动脉闭塞
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系统性红斑狼疮（SLE）与动脉粥样硬化相关，但是SLE和外周动脉闭塞疾病（PAOD）仍不清楚。研究者旨在调查SLE患者及非SLE患者心血管并发症的关系。从台湾医疗保险研究数据库中收集2000年到2011年期间患者的数据。SLE患者，按照年龄，性别及糖尿病史与非SLE患者进行配对。研究者评估了心血管并发症，包括高血压，DM，卒中，慢性阻塞性肺疾病，心衰，冠心病及高血脂。这篇研究共有10144名SLE

系统性红斑狼疮（SLE）与动脉粥样硬化相关，但是SLE和外周动脉闭塞疾病（PAOD）仍不清楚。研究者旨在调查SLE患者及非SLE患者心血管并发症的关系。

从台湾医疗保险研究数据库中收集2000年到2011年期间患者的数据。SLE患者，按照年龄、性别及糖尿病史与非SLE患者进行配对。研究者评估了心血管并发症，包括高血压、DM、卒中、慢性阻塞性肺疾病、心衰、冠心病及高血脂。

这篇研究共有10144名SLE患者，10144名对照组患者。SLE组发生PAOD的概率是非SLE组的9.39倍（95%CI: 7.70-11.15）。并且，SLE是PAOD独立的风险因素。年龄≤34岁的SLE患者PAOD的校正风险是最高的（HR=47.6，95% CI = 26.8-84.4）。随访第一年PAOD的风险是最高的，但随着时间逐渐下降。


与一般人群相比，SLE患者发生PAOD的风险更高。在SLE年轻患者及疾病早期时，PAOD的风险显著升高。

原文出处：

Chuang YW, Yu MC, Lin CL, et al. Risk of Peripheral Arterial Occlusive Disease in Patients With Systemic Lupus Erythematosus: A Nationwide Population-Based Cohort Study. Medicine (Baltimore). 2015 Nov.

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    2016-07-18 kalseyzl

    #CIN#

    0

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    2016-03-05 ms7019579240139182

    #动脉闭塞#

    0

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    2016-08-02 qingrejiedu

    #系统性#

    0

  4. 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authenticateStatus=null, createdAvatar=, createdBy=e4e21675717, createdName=卡莲, createdTime=Tue Jan 05 08:51:00 CST 2016, time=2016-01-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1387163, encodeId=42fd138e16363, content=<a href='/topic/show?id=8a3a6814425' target=_blank style='color:#2F92EE;'>#狼疮#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=68144, encryptionId=8a3a6814425, topicName=狼疮)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7a6e2500005, createdName=sunrural_42825357, createdTime=Tue Dec 01 12:16:00 CST 2015, time=2015-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1436065, encodeId=284a1436065ab, content=<a href='/topic/show?id=22f8e71238d' target=_blank style='color:#2F92EE;'>#红斑#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77123, encryptionId=22f8e71238d, topicName=红斑)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Dec 01 12:16:00 CST 2015, time=2015-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1577445, encodeId=209715e7445e7, content=<a href='/topic/show?id=cda91148004' target=_blank style='color:#2F92EE;'>#Medicine#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11480, encryptionId=cda91148004, topicName=Medicine)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=54cd16396700, createdName=ms1692212821629096, createdTime=Tue Dec 01 12:16:00 CST 2015, time=2015-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1593262, encodeId=59ef1593262b8, content=<a href='/topic/show?id=8d1342e95fa' target=_blank style='color:#2F92EE;'>#外周动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42795, encryptionId=8d1342e95fa, topicName=外周动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b27818121614, createdName=wujh_7312825, createdTime=Tue Dec 01 12:16:00 CST 2015, time=2015-12-01, status=1, ipAttribution=)]
    2016-05-21 jeanqiuqiu

    #DIC#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1773515, encodeId=44641e7351587, content=<a href='/topic/show?id=5f014e1852' target=_blank style='color:#2F92EE;'>#CIN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4718, encryptionId=5f014e1852, topicName=CIN)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9a038523631, createdName=kalseyzl, createdTime=Mon Jul 18 01:16:00 CST 2016, time=2016-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2022177, encodeId=a54a20221e769, content=<a href='/topic/show?id=cbec3334967' target=_blank style='color:#2F92EE;'>#动脉闭塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33349, encryptionId=cbec3334967, topicName=动脉闭塞)], attachment=null, authenticateStatus=null, 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GetPortalCommentsPageByObjectIdResponse(id=1593262, encodeId=59ef1593262b8, content=<a href='/topic/show?id=8d1342e95fa' target=_blank style='color:#2F92EE;'>#外周动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42795, encryptionId=8d1342e95fa, topicName=外周动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b27818121614, createdName=wujh_7312825, createdTime=Tue Dec 01 12:16:00 CST 2015, time=2015-12-01, status=1, ipAttribution=)]
    2016-01-05 卡莲

    临床上值得注意

    0

  6. 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GetPortalCommentsPageByObjectIdResponse(id=1593262, encodeId=59ef1593262b8, content=<a href='/topic/show?id=8d1342e95fa' target=_blank style='color:#2F92EE;'>#外周动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42795, encryptionId=8d1342e95fa, topicName=外周动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b27818121614, createdName=wujh_7312825, createdTime=Tue Dec 01 12:16:00 CST 2015, time=2015-12-01, status=1, ipAttribution=)]
    2016-01-05 卡莲

    值得收藏

    0

  7. 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GetPortalCommentsPageByObjectIdResponse(id=1593262, encodeId=59ef1593262b8, content=<a href='/topic/show?id=8d1342e95fa' target=_blank style='color:#2F92EE;'>#外周动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42795, encryptionId=8d1342e95fa, topicName=外周动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b27818121614, createdName=wujh_7312825, createdTime=Tue Dec 01 12:16:00 CST 2015, time=2015-12-01, status=1, ipAttribution=)]
    2015-12-01 sunrural_42825357

    #狼疮#

    0

  8. 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topicName=null, topicId=null, topicList=[TopicDto(id=77123, encryptionId=22f8e71238d, topicName=红斑)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Tue Dec 01 12:16:00 CST 2015, time=2015-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1577445, encodeId=209715e7445e7, content=<a href='/topic/show?id=cda91148004' target=_blank style='color:#2F92EE;'>#Medicine#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11480, encryptionId=cda91148004, topicName=Medicine)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=54cd16396700, createdName=ms1692212821629096, createdTime=Tue Dec 01 12:16:00 CST 2015, time=2015-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1593262, encodeId=59ef1593262b8, content=<a href='/topic/show?id=8d1342e95fa' target=_blank style='color:#2F92EE;'>#外周动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42795, encryptionId=8d1342e95fa, topicName=外周动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b27818121614, createdName=wujh_7312825, createdTime=Tue Dec 01 12:16:00 CST 2015, time=2015-12-01, status=1, ipAttribution=)]
    2015-12-01 zhouqu_8

    #红斑#

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1773515, encodeId=44641e7351587, content=<a href='/topic/show?id=5f014e1852' target=_blank style='color:#2F92EE;'>#CIN#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4718, encryptionId=5f014e1852, topicName=CIN)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9a038523631, createdName=kalseyzl, createdTime=Mon Jul 18 01:16:00 CST 2016, time=2016-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2022177, encodeId=a54a20221e769, content=<a href='/topic/show?id=cbec3334967' target=_blank style='color:#2F92EE;'>#动脉闭塞#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33349, encryptionId=cbec3334967, topicName=动脉闭塞)], attachment=null, authenticateStatus=null, 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    2015-12-01 ms1692212821629096

    #Medicine#

    0

  10. 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GetPortalCommentsPageByObjectIdResponse(id=1593262, encodeId=59ef1593262b8, content=<a href='/topic/show?id=8d1342e95fa' target=_blank style='color:#2F92EE;'>#外周动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42795, encryptionId=8d1342e95fa, topicName=外周动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b27818121614, createdName=wujh_7312825, createdTime=Tue Dec 01 12:16:00 CST 2015, time=2015-12-01, status=1, ipAttribution=)]
    2015-12-01 wujh_7312825

    #外周动脉#

    0

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关节表现常常是系统性红斑狼疮(SLE)患者最常见和最早出现的临床症状。临床判断SLE的关节病变常应用ACR非侵蚀性关节炎的诊断标准，但SLE也有非侵蚀性变形性关节炎（Jaccoud关节）和伴关节侵蚀畸形的关节炎（Rhupus综合征）。而目前对SLE关节炎的研究却较少。 为了探讨核磁共振(MRI)在SLE关节炎的诊断价值和SLE关节炎的临床特点，爱尔兰的Ball教授等做了一项病例对照研究，

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由中科院上海药物研究所左建平研究组与李英研究员历时15年研发的治疗系统性红斑狼疮的1.1类候选新药“马来酸蒿乙醚胺”日前获国家食品药品监督管理总局（SFDA）核准的I、II、III期临床研究批件，即将启动临床研究。系统性红斑狼疮（SLE）是一种难治的自身免疫性疾病，临床上长期缺乏新型治疗药物。目前SLE临床治疗仍然以糖皮质激素为基础，联合使用非特异性抗炎、免疫抑制剂，但长期使用易造成免疫功能低下等

一图读懂：系统性红斑狼疮

NEJM：雅库关节炎(Jaccoud''s Arthropathy)病例报道

一名58岁的男性患者，以往有15年的系统性红斑狼疮病史，今次来院就诊的主要症状表现为多发性关节炎、对光敏感、颧部红斑和胸膜炎。实验室检查发现抗核抗体，抗–双链DNA抗体，抗Ro（SS-A）抗体，非–肾病范围的蛋白尿，以及白细胞减少症。类风湿因子和抗CCP抗体检测结果均为阴性。尽管在10年前开始使用糖皮质激素、羟氯喹和硫唑嘌呤进行治疗，但最终还是出现了手部畸形，包括天鹅颈畸形，Z畸形拇指，小指尺偏差

AIM：系统性红斑狼疮女性患者妊娠结局的预测因子

由于系统性红斑狼疮（SLE）影响生育年龄的女性，所以对她们来说怀孕是一个大问题。该研究的目的是为了识别稳定期或活动期SLE患者的不良妊娠结局（APOs）预测因子。该研究是一项前瞻性、多中心的队列研究。共有385例（49％为非西班牙裔白人；31％先前有肾炎）SLE患者参加了PROMISSE（妊娠结局的预测：在抗磷脂抗体综合征和系统性红斑狼疮标志物）研究。排除标准为尿蛋白肌酐比值大于1000mg/g，