Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.
Clin Exp Rheumatol. 2013 Mar-Apr;31(2 Suppl 76):46-9. Epub 2013 Jul 22.
To investigate the clinical characteristics of SSc patients with DUs in China.
The data of 267 consecutive SSc patients based on the EUSTAR DATABASE from Peking Union Medical College Hospital from February 2009 to March 2012 were prospectively collected. The patients with DUs were compared to those without DUs.
Seventy-nine patients (29.6%) had DUs out of 267 SSc patients analysed. There were significant differences between patients with and without DU based on sex (female/male: 65/14 vs. 174/14), age of onset of SSc (32.3±11.7 vs. 40.4±12.6 y), age of onset of Raynaud's phenomenon (31.8±12.3 vs. 38.7±12.2) (p<0.05). In addition, there was a higher rate of diffuse SSc, gastrointestinal involvement, (especially esophageal involvement), and pericardial effusion, higher mRodnan score, and more anti-scl70 antibody positivity in patients with DU (p<0.05). A multivariate analysis identified anti-Scl70 antibody positivity, gastrointestinal involvement and a younger age at disease onset as three risk factors for developing DUs in SSc patients.
The occurrence of DUs in Chinese SSc patients is frequent. It is possible that SSc patients with DUs were influenced by the disease earlier in life, which should be detected early for effective intervention.
研究中国系统性硬化症(SSc)患者发生糖尿病足溃疡(DFU)的临床特征。
前瞻性收集 2009 年 2 月至 2012 年 3 月北京协和医院依据 EULAR 硬皮病临床试验研究联盟(EUSTAR)数据库的 267 例 SSc 患者的临床资料。比较发生 DFU 与未发生 DFU 的 SSc 患者的临床特征。
267 例 SSc 患者中,79 例(29.6%)发生了 DFU。DFU 组与未发生 DFU 组的患者在性别[女性/男性:65/14 例比 174/14 例]、SSc 发病年龄[(32.3±11.7)岁比(40.4±12.6)岁]、雷诺现象发病年龄[(31.8±12.3)岁比(38.7±12.2)岁]等方面差异均有统计学意义(均 P<0.05)。此外,DFU 组弥漫型 SSc、胃肠道受累(尤其是食管受累)、心包积液的发生率较高,mRodnan 评分较高,抗 Scl70 抗体阳性率较高(均 P<0.05)。多因素分析显示,抗 Scl70 抗体阳性、胃肠道受累及发病年龄较小是 SSc 患者发生 DFU 的 3 个危险因素。
中国 SSc 患者 DFU 的发生率较高。可能提示 SSc 患者更早地受到疾病的影响,应早期检测,以便进行有效干预。