Helfrich D J, Banner B, Steen V D, Medsger T A
Department of Medicine, University of Pittsburgh School of Medicine, Pennsylvania 15261.
Arthritis Rheum. 1989 Sep;32(9):1128-34. doi: 10.1002/anr.1780320911.
Of 140 patients with "scleroderma renal crisis" encountered during a 33-year period, 15 of 131 (11%) whose blood pressures were recorded were normotensive during this complication. In comparison with 116 patients with hypertension, the normotensive patients significantly more often had microangiopathic hemolytic anemia (90% versus 38%) and thrombocytopenia (83% versus 21%). Pulmonary hemorrhage occurred in 6 normotensive patients. More normotensive patients had received high doses of corticosteroids (prednisone greater than or equal to 30 mg/day) during the 2 months immediately preceding renal crisis (64% versus 16%). A role for corticosteroids in precipitating renal crisis is suggested. The 12-month survival was significantly reduced in the normotensive patients (13% versus 35%).
在33年期间遇到的140例“硬皮病肾危象”患者中，131例有血压记录，其中15例（11%）在该并发症期间血压正常。与116例高血压患者相比，血压正常的患者微血管病性溶血性贫血更为常见（90%对38%），血小板减少也更常见（83%对21%）。6例血压正常的患者发生了肺出血。在肾危象前2个月内，更多血压正常的患者接受了高剂量皮质类固醇治疗（泼尼松≥30mg/天）（64%对16%）。提示皮质类固醇在引发肾危象中起作用。血压正常患者的12个月生存率显著降低（13%对35%）。
