Department of Medicine, Kidney Center, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku, Tokyo, Japan.
Clin Rheumatol. 2011 Nov;30(11):1499-505. doi: 10.1007/s10067-011-1838-7. Epub 2011 Sep 2.
The validity of the Birmingham Vasculitis Activity Score (BVAS) as an index of disease activity and a predictor of the prognosis and outcome in patients with MPA has not yet been established in Japan. We conducted a retrospective study of the data of 73 patients with MPA who were followed up for at least 2 years. We divided the patients into two groups according to the BVAS, namely, the high-BVAS group (≥16) and the low-BVAS group (<16), and compared the clinical characteristics. In addition, the distribution of the BVAS items in the patients and the items contributing to the total score in MPA patients were analyzed. Remission was achieved in 85% of patients at 1 month. There were no significant differences in the serum CRP, creatinine (Cre), or MPO-ANCA between the high- and low-BVAS group; however, the survival time was significantly shorter (p = 0.048) and the mortality rate significantly higher in the high-BVAS group (p = 0.04). The items of the BVAS contributing to the total score were motor neuropathy, sensory neuropathy, pulmonary infiltrate, hematuria, proteinuria, Cre ≥5.6 mg/dL, hypertension, scleritis, rise in Cre by ≥30%, and myalgia. BVAS was found to be a useful tool for determining the disease activity and outcome in patients with MPA in Japan. The initial BVAS was also predictive of the mortality and survival time and can also be used as a prognostic tool; therefore, use of the tool may facilitate the selection of appropriate treatment.
Birmingham 血管炎活动评分 (BVAS) 作为疾病活动的指标以及预测 MPA 患者预后和结局的指标，在日本尚未得到证实。我们对至少随访 2 年的 73 例 MPA 患者的数据进行了回顾性研究。我们根据 BVAS 将患者分为高 BVAS 组（≥16）和低 BVAS 组（<16），并比较了临床特征。此外，分析了患者中 BVAS 项目的分布以及对 MPA 患者总分有贡献的项目。在 1 个月时，85%的患者达到缓解。高 BVAS 组和低 BVAS 组之间的血清 CRP、肌酐（Cre）或 MPO-ANCA 无显著差异；然而，高 BVAS 组的生存时间明显更短（p=0.048），死亡率明显更高（p=0.04）。对总分有贡献的 BVAS 项目为运动神经病、感觉神经病、肺部浸润、血尿、蛋白尿、Cre≥5.6mg/dL、高血压、巩膜炎、Cre 升高≥30%以及肌痛。BVAS 被认为是评估日本 MPA 患者疾病活动和结局的有用工具。初始 BVAS 也可预测死亡率和生存时间，也可用作预后工具；因此，该工具的使用可能有助于选择合适的治疗方法。
