Lee Jason J, Pope Janet E
Arthritis Res Ther. 2014 Sep 25;16(5):435. doi: 10.1186/s13075-014-0435-y.
We performed a meta-analysis to investigate the risk of deep vein thrombosis (DVT) and/or pulmonary embolisms (PEs) in patients with inflammatory arthritis, vasculitis and connective tissue diseases (CTDs) (systemic lupus erythematosus (SLE), Sjögren's syndrome, inflammatory myositis and systemic sclerosis (SSc)).
PubMed, Embase, the Cochrane databases and MEDLINE were searched to identify full-text English-language publications about adult patients with rheumatologic inflammatory diseases and venous thromboembolisms (VTEs). Data regarding rates of DVTs and PEs were extracted. Using random-effects models, pooled estimates for VTEs in individual and pooled diseases were compared with matched populations where possible. Studies were excluded if VTEs were described in the setting of pregnancy, postoperative outcomes or solely antiphospholipid antibody syndrome.
Most of the 5,206 studies were excluded because they did not state the rate or incidence of VTEs. In total, 25 studies remained for analysis. Ten studies that included rheumatoid arthritis comprised an aggregate of 5,273,942 patients and 891,530,181 controls with a cumulative VTE incidence of 2.18% (95% confidence interval (CI): 1.82% to 2.54%) and an odds ratio of 2.23 (95% CI: 2.02 to 2.47) compared to age- and sex-matched populations. Ten studies comprised an aggregate of 54,697 SLE patients with a cumulative VTE incidence of 7.29% (95% CI: 5.82% to 8.75%). Four Sjögren's syndrome studies comprising an aggregate of 25,100 patients demonstrated a cumulative VTE incidence of 2.18% (95% CI: 0.79% to 3.57%). Four studies of inflammatory myositis comprising an aggregate of 8,245 patients yielded a cumulative VTE incidence of 4.03% (95% CI: 2.38% to 5.67%). The SSc- and antineutrophil cytoplasmic antibody vasculitis-related cumulative VTE rates (four studies each) were 3.13% and 7.97%, respectively.
The inflammatory rheumatologic diseases studied were all associated with high rates of VTEs-more than three times higher than in the general population.
我们进行了一项荟萃分析，以调查炎症性关节炎、血管炎和结缔组织病（CTD）（系统性红斑狼疮（SLE）、干燥综合征、炎性肌病和系统性硬化症（SSc））患者发生深静脉血栓形成（DVT）和/或肺栓塞（PE）的风险。
检索了PubMed、Embase、Cochrane数据库和MEDLINE，以确定关于患有风湿性炎症性疾病和静脉血栓栓塞症（VTE）的成年患者的英文全文出版物。提取了有关DVT和PE发生率的数据。使用随机效应模型，将个体疾病和合并疾病中VTE的汇总估计值与可能匹配的人群进行比较。如果VTE是在妊娠、术后结果或仅抗磷脂抗体综合征的背景下描述的，则排除相关研究。
5206项研究中的大多数被排除，因为它们未说明VTE的发生率或发病率。总共剩下25项研究用于分析。包括类风湿关节炎的10项研究共纳入5273942例患者和891530181例对照，与年龄和性别匹配的人群相比，累积VTE发生率为2.18%（95%置信区间（CI）：1.82%至2.54%），比值比为2.23（95%CI：2.02至2.47）。10项研究共纳入54697例SLE患者，累积VTE发生率为7.29%（95%CI：5.82%至8.75%）。四项关于干燥综合征的研究共纳入25100例患者，累积VTE发生率为2.18%（95%CI：0.79%至3.57%）。四项关于炎性肌病的研究共纳入了8245例患者，累积VTE发生率为4.03%（95%CI：2.38%至5.67%）。与SSc和抗中性粒细胞胞浆抗体血管炎相关的累积VTE发生率（各有四项研究）分别为3.13%和7.97%。
所研究的炎症性风湿性疾病均与高VTE发生率相关——比普通人群高出三倍多。
