Magnani L, Versari A, Salvo D, Casali M, Germanò G, Meliconi R, Pulsatelli L, Formisano D, Bajocchi G, Pipitone N, Boiardi L, Salvarani C
Struttura Complessa di Reumatologia, Arcispedale S. Maria Nuova, Viale Risorgimento 80, Reggio Emilia, Italy.
Reumatismo. 2011;63(2):86-90. doi: 10.4081/reumatismo.2011.86.
Disease activity assessment in large vessel vasculitis (LVV) is often challenging for physicians. In this study, we compared the assessment of disease activity based on inflammatory markers, clinical indices (Indian Takayasu Activity Score [ITAS] and the Kerr/National Institute of Health indices [Kerr/NIH]), and 18F-Fluorodesossiglucose (FGD) vascular uptake at positron emission tomography (Pet). We found that Pet results did not statistically correlate with the clinical indices ITAS and Kerr/NIH, because FDG uptake was increased (grade>2 on a 0-3 scale in at least one evaluated vascular segment) in many patients with inactive disease according to clinical and laboratory parameters (i.e., negative ITAS and Kerr/NIH indices as well as normal erythrocyte sedimentation rate (ESR) and C-reactive protein (PCR)). Similarly, interleukin- 6 and its soluble receptor did not statistically correlate with disease activity. In contrast, clinical indices showed a significant correlation between each other and with inflammatory markers (VES and PCR). These data suggest that while clinical indices and inflammatory markers may be useful to assess disease activity, Pet may be more sensitive.
对医生来说,大血管血管炎(LVV)的疾病活动评估往往具有挑战性。在本研究中,我们比较了基于炎症标志物、临床指标(印度大动脉炎活动评分[ITAS]和克尔/美国国立卫生研究院指标[Kerr/NIH])以及正电子发射断层扫描(Pet)时18F-氟脱氧葡萄糖(FGD)血管摄取情况的疾病活动评估。我们发现,Pet结果与临床指标ITAS和Kerr/NIH在统计学上无相关性,因为根据临床和实验室参数(即ITAS和Kerr/NIH指标为阴性以及红细胞沉降率(ESR)和C反应蛋白(PCR)正常),许多疾病不活动的患者FDG摄取增加(在至少一个评估的血管节段中0-3级评分>2)。同样,白细胞介素-6及其可溶性受体与疾病活动在统计学上无相关性。相比之下,临床指标彼此之间以及与炎症标志物(VES和PCR)显示出显著相关性。这些数据表明,虽然临床指标和炎症标志物可能有助于评估疾病活动,但Pet可能更敏感。