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405 例系统性硬化症日本患者的临床特征。

Clinical features of 405 Japanese patients with systemic sclerosis.

机构信息

Department of Rheumatology and Infectious Diseases, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan.

出版信息

Mod Rheumatol. 2012 Apr;22(2):272-9. doi: 10.1007/s10165-011-0515-7. Epub 2011 Aug 28.

Abstract

We aimed to clarify the clinical features of Japanese patients with systemic sclerosis (SSc), especially with reference to organ involvement and autoantibodies. A cohort of 405 patients with SSc who attended our institution from 1973 to 2008 was identified retrospectively. Data on clinical features, including autoantibodies, organ involvement, and overlap of other connective tissue diseases, were obtained by following the medical records until 2009. The percentage of male patients during or after 1990 was greater than that before 1990 (3.9 vs. 10.6%, respectively). Limited cutaneous SSc (lSSc) was twice as frequent as diffuse cutaneous SSc (dSSc). About half of the patients had lung involvement (50.4%), while only 3.2% had scleroderma renal crisis. Male gender was associated with lung involvement, and dSSc was associated with most organ involvements except for pulmonary arterial hypertension (PAH). Anti-Scl-70 antibody was associated with lung or heart involvement, while anti-U1-RNP antibody was only associated with PAH. Conversely, patients with anti-centromere antibody had less organ involvement. SSc-Sjögren overlap syndrome was related to lSSc, further overlapping systemic lupus erythematosus (SLE), and less lung or heart involvement. In conclusion, these results not only confirmed previous reports but revealed several other findings, such as the increased proportion of male patients in recent years and the relationships between clinical features.

摘要

我们旨在阐明日本系统性硬化症(SSc)患者的临床特征,特别是与器官受累和自身抗体有关。回顾性地确定了 1973 年至 2008 年期间在我们机构就诊的 405 例 SSc 患者的队列。通过查阅病历获得了包括自身抗体、器官受累和重叠性结缔组织病在内的临床特征数据,直至 2009 年。1990 年或之后的男性患者比例大于 1990 年之前的男性患者比例(分别为 3.9%和 10.6%)。局限性皮肤型 SSc(lSSc)的发生率是弥漫性皮肤型 SSc(dSSc)的两倍。大约一半的患者有肺部受累(50.4%),而只有 3.2%的患者发生硬皮病肾危象。男性与肺部受累有关,dSSc 与大多数器官受累有关,除肺动脉高压(PAH)外。抗 Scl-70 抗体与肺部或心脏受累有关,而抗 U1-RNP 抗体仅与 PAH 有关。相反,抗着丝点抗体的患者器官受累较少。SSc-Sjögren 重叠综合征与 lSSc 相关,进一步重叠系统性红斑狼疮(SLE),且肺部或心脏受累较少。总之,这些结果不仅证实了以前的报告,还揭示了其他一些发现,例如近年来男性患者比例增加以及临床特征之间的关系。

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