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硅胶植入后200例亚洲综合征病例:30年的比较研究及当前文献综述

Two hundreds cases of ASIA syndrome following silicone implants: a comparative study of 30 years and a review of current literature.

作者信息

Colaris Maartje J L, de Boer Mintsje, van der Hulst Rene R, Cohen Tervaert Jan Willem

机构信息

Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.

Reconstructive, Plastic and Hand Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.

出版信息

Immunol Res. 2017 Feb;65(1):120-128. doi: 10.1007/s12026-016-8821-y.

Abstract

In this study, we compared one hundred patients with autoimmune/inflammatory syndrome induced by adjuvants (ASIA) due to silicone implant incompatibility syndrome diagnosed in 2014 in Maastricht, the Netherlands, with one hundred historical patients with adjuvant breast disease diagnosed in the Baylor College of Medicine, Houston, USA, between 1985 and 1992. Similarities and differences between these two cohorts were identified to determine whether the spectrum of silicone-related disease changed during the last 30 years. Patients with complaints possibly due to silicone-filled breast implants were prospectively examined in the Reinaert Clinic, Maastricht, the Netherlands between January 2014 and October 2014. All patients were evaluated for the fulfilment of ASIA criteria. Results were compared to results of the Baylor College cohort and 18 other reviewed historical cohorts. Clinical manifestations between the Maastricht and Baylor College cohorts were comparable. Fatigue was observed in 98 current patients and in 95 historical patients. Arthralgia was observed in 91 versus 81 historical patients. Myalgia was observed in 54 versus 91 patients. Cognitive impairment was observed in 78 versus 81 patients, pyrexia was observed in 64 versus 52 patients, sicca complaints in 73 versus 72 patients and severe neurological manifestations in 20 versus 32 patients. From the 54 patients who underwent removal of their silicone breast implant, 50 % (n = 27) of the patients experienced improvement of complaints after explantation of the implant. Also, in the 18 reviewed historical cohorts, similar clinical manifestations were described. Our findings suggest that no major changes were present in the observed clinical manifestations between the Maastricht and Baylor College cohorts. Also, despite changes in the principal constituents of the silicone implants during the past fifty years, silicone remained an adjuvant that may 'bleed' and subsequently may be a chronic stimulus to the immune system resulting in similar clinical manifestations as observed in the Maastricht cohort, the Baylor College cohort and 18 other large cohorts of patients. We therefore conclude that silicone-related disease has not changed during the last 30 years.

摘要

在本研究中,我们将2014年在荷兰马斯特里赫特被诊断为因硅胶植入物不相容综合征导致的佐剂诱导的自身免疫/炎症综合征(ASIA)的100例患者,与1985年至1992年间在美国休斯顿贝勒医学院被诊断为佐剂性乳腺病的100例历史患者进行了比较。确定这两个队列之间的异同,以判断在过去30年中与硅胶相关疾病的范围是否发生了变化。2014年1月至10月期间,在荷兰马斯特里赫特的雷纳特诊所对可能因硅胶填充乳房植入物而出现不适的患者进行了前瞻性检查。所有患者均评估是否符合ASIA标准。将结果与贝勒医学院队列以及其他18个经审查的历史队列的结果进行比较。马斯特里赫特队列和贝勒医学院队列的临床表现具有可比性。在98例现患患者和95例历史患者中观察到疲劳。在91例现患患者和81例历史患者中观察到关节痛。在54例现患患者和91例历史患者中观察到肌痛。在78例现患患者和81例历史患者中观察到认知障碍,在64例现患患者和52例历史患者中观察到发热,在73例现患患者和72例历史患者中观察到干燥症状,在20例现患患者和32例历史患者中观察到严重神经表现。在接受硅胶乳房植入物取出术的54例患者中,50%(n = 27)的患者在植入物取出后不适症状有所改善。此外,在18个经审查的历史队列中,也描述了类似的临床表现。我们的研究结果表明,马斯特里赫特队列和贝勒医学院队列之间观察到的临床表现没有重大变化。此外,尽管在过去五十年中硅胶植入物的主要成分发生了变化,但硅胶仍然是一种可能“渗出”并随后可能对免疫系统产生慢性刺激的佐剂,导致与马斯特里赫特队列、贝勒医学院队列以及其他18个大型患者队列中观察到的类似临床表现。因此,我们得出结论,在过去30年中与硅胶相关的疾病没有变化。

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