Institute of Rheumatology, Belgrade, Serbia.
Rheumatol Int. 2013 Apr;33(4):921-6. doi: 10.1007/s00296-012-2484-3. Epub 2012 Jul 22.
To assess the prognostic value of the age at onset of Raynaud's (RP) and of a history of exacerbation of RP attacks for the development of connective tissue disease (CTD) in patients initially found to have primary Raynaud's. 3,035 patients with primary RP (2,702 women and 333 men) were followed for an average of 4.8 years (range from 1 to 10 years). At baseline and every 6 months, they were screened for signs and symptoms of CTD. At 4.8 years of follow-up, 54.7 % patients remained as primary RP, 8.1 % had developed suspected secondary RP, and 37.2 % had developed a definite CTD. Primary RP patients had an earlier onset of RP (mean age of 32.2 years) than those with suspected (mean age 36.5 years, P = .007) or definite secondary RP associated with CTD (mean age of 39.8 years, P = .004). RP beginning before the age of forty was not significantly associated with the development of CTD. Conversely, the appearance of RP after the age of 40 was significantly associated with the development of CTD (P = .00001). Worsening of RP attacks predicted the development of CTD, especially systemic sclerosis (relative risk [RR] of 1.42), scleroderma overlap syndrome (RR of 1.18), and mixed CTD (RR of 1.18). Patients whose onset of RP occurred past 40 years of age and those with worsening RP attacks were at risk for the future development of CTD.
为了评估雷诺现象（RP）发病年龄和 RP 发作恶化史对最初诊断为原发性 RP 患者发生结缔组织病（CTD）的预后价值。对 3035 例原发性 RP 患者（2702 名女性和 333 名男性）进行了平均 4.8 年（1 至 10 年）的随访。在基线和每 6 个月，对他们进行 CTD 体征和症状筛查。在 4.8 年的随访中，54.7%的患者仍为原发性 RP，8.1%的患者发展为疑似继发性 RP，37.2%的患者发展为明确的 CTD。原发性 RP 患者的 RP 发病年龄较早（平均年龄 32.2 岁），而疑似继发性 RP（平均年龄 36.5 岁，P=0.007）或与 CTD 相关的明确继发性 RP（平均年龄 39.8 岁，P=0.004）患者的 RP 发病年龄较晚。40 岁以前出现 RP 与 CTD 的发生无显著相关性。相反，40 岁以后出现 RP 与 CTD 的发生显著相关（P=0.00001）。RP 发作恶化预测 CTD 的发生，尤其是系统性硬化症（RR 为 1.42）、重叠综合征（RR 为 1.18）和混合性 CTD（RR 为 1.18）。RP 发病年龄超过 40 岁且 RP 发作恶化的患者有发生 CTD 的风险。
