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系统性硬化症早期患者疾病较轻?

Less severe disease in patients with early systemic sclerosis?

机构信息

Rheumatology Division, Universidade Federal do Mato Grosso do Sul, Mato Grosso do Sul, Brazil.

Rheumatology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.

出版信息

Mod Rheumatol. 2019 Nov;29(6):977-983. doi: 10.1080/14397595.2018.1551265. Epub 2019 Jan 3.

Abstract

To evaluate the disease severity and activity in patients with a diagnosis of systemic sclerosis (SSc) after the 2013 American College of Rheumatology and the European League Against Rheumatism (ACR/EULAR) classification criteria development compared to patients diagnosed before 2013. One hundred and fifty-four subjects were included and assigned to the following groups: 120 SSc patients meeting the 1980 ACR criteria and with a diagnosis before 2013 (historical group), and 34 patients diagnosed after 2013, fulfilling the new ACR/EULAR criteria (early SSc group). Disease activity was assessed by the 2001 European Scleroderma Study Group Activity Index (EScSG-AI) and by the revised European Scleroderma Trials and Research group (EUSTAR) activity index. Disease severity was assessed using the Medsger Disease Severity Scale (DSS) and the summed DSS score. The time between the first non-Raynaud's symptom and the diagnosis was shorter in early SSc than in the historical group ( = .001). The EScSG-AI and the EUSTAR activity index were similar between groups. The summed DSS score and the general, skin and gastrointestinal tract DSS scores were significantly lower in early SSc than in the historical group. SSc patients with a diagnosis after the new ACR/EULAR criteria development were diagnosed earlier and had a less severe disease than historical patients.

摘要

评估 2013 年美国风湿病学会(ACR)和欧洲抗风湿病联盟(EULAR)分类标准制定后诊断为系统性硬化症(SSc)的患者与 2013 年前诊断为 SSc 的患者的疾病严重程度和活动度。共纳入 154 例患者,分为以下两组:120 例符合 1980 年 ACR 标准且 2013 年前诊断的 SSc 患者(历史组),34 例符合新 ACR/EULAR 标准的 2013 年后诊断的 SSc 患者(早期 SSc 组)。采用 2001 年欧洲硬皮病研究组活动指数(EScSG-AI)和修订的欧洲硬皮病临床试验和研究组(EUSTAR)活动指数评估疾病活动度。采用 Medsger 疾病严重程度量表(DSS)和总和 DSS 评分评估疾病严重程度。早期 SSc 组中,从首发非雷诺现象症状到诊断的时间短于历史组( = .001)。两组间 EScSG-AI 和 EUSTAR 活动指数相似。早期 SSc 组的总和 DSS 评分和一般、皮肤和胃肠道 DSS 评分均显著低于历史组。新 ACR/EULAR 标准制定后诊断为 SSc 的患者比历史患者更早诊断,疾病严重程度较轻。

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