Oh Yoon-Jeong, Ahn Sung Soo, Park Eun Seong, Jung Seung Min, Song Jason Jungsik, Park Yong-Beom, Lee Sang-Won
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Republic of Korea.
Rheumatol Int. 2017 May;37(5):685-694. doi: 10.1007/s00296-017-3706-5. Epub 2017 Mar 24.
The objective of this study was to investigate whether clinical and laboratory data, Birmingham vasculitis activity score (BVAS) and five factor scores (FFS) at diagnosis could predict relapse in 30 patients with polyarteritis nodosa (PAN) having the follow-up duration for over 12 months. We reviewed the medical charts of 30 patients with PAN. We obtained clinical and laboratory data at diagnosis, and we compared them between the two groups based on relapse. The optimal cut-off values of BVAS and FFS (1996) at diagnosis to predict relapse were extrapolated. The mean age of patients (15 men) was 50.8 years, and the mean follow-up duration was 64.1 months. Nine patients (30.0%) had experience relapse after remission. Patients having relapse showed the higher frequency of weight loss and ocular symptoms and the less frequency of diastolic hypertension than those having not (p < 0.005 for all). On multivariate logistic regression analysis, weight loss was the only independent predictor of relapse, but on Cox Hazard model analysis, its statistical significance disappeared. The mean initial BVAS and FFS (1996) of patients in relapse group were higher than those of patients in no relapse group (p < 0.005 for all). Patients having initial BVAS over 13.5 and FFS (1996) over 1 exhibited significantly higher risk of relapse than those having not (RR 40.0 and RR 7.0, respectively). However, initial BVAS over 13.5 only remained significant in Kaplan-Meier survival analysis. In conclusion, BVAS over 13.5 at diagnosis was the only independent predictor of relapse of PAN.
本研究的目的是调查30例结节性多动脉炎（PAN）患者在诊断时的临床和实验室数据、伯明翰血管炎活动评分（BVAS）及五因素评分（FFS）是否能够预测随访时间超过12个月的复发情况。我们回顾了30例PAN患者的病历。获取了诊断时的临床和实验室数据，并根据复发情况在两组之间进行比较。推断出诊断时BVAS和FFS（1996年）预测复发的最佳临界值。患者平均年龄为50.8岁（15名男性），平均随访时间为64.1个月。9例患者（30.0%）缓解后复发。复发患者体重减轻和眼部症状的发生率高于未复发患者，舒张压升高的发生率低于未复发患者（所有p值均<0.005）。多因素逻辑回归分析显示，体重减轻是复发的唯一独立预测因素，但在Cox风险模型分析中，其统计学意义消失。复发组患者的初始BVAS和FFS（1996年）平均值高于未复发组患者（所有p值均<0.005）。初始BVAS超过13.5且FFS（1996年）超过1的患者复发风险显著高于未超过者（相对风险分别为40.0和7.0）。然而，仅初始BVAS超过13.5在Kaplan-Meier生存分析中仍具有显著性。总之，诊断时BVAS超过13.5是PAN复发的唯一独立预测因素。
