Li Jing, Wang Yahong, Wang Yanhong, Wang Ying, Yang Yunjiao, Zhao Jiuliang, Li Mengtao, Tian Xinping, Zeng Xiaofeng
Department of Rheumatology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, 100730, China.
Department of Ultrasound Imaging, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.
Arthritis Res Ther. 2020 Dec 10;22(1):285. doi: 10.1186/s13075-020-02365-y.
To investigate the association between blood biomarkers and disease activity of Takayasu's arteritis (TAK) in a follow-up cohort.
Disease activity was assessed by clinical manifestations and repeated vascular Doppler examinations. The association between erythrocyte sedimentation rate (ESR), serum levels of high-sensitive C-reactive protein (hsCRP), interleukin-6(IL-6), and tumor necrosis factor-α (TNFα) and disease activity were analyzed by logistic regression and survival analysis. Kaplan-Meier method was used to estimate the cumulative remission rate curve, log-rank tests for group comparison, and Cox regression for estimating hazard ratios of these parameters for disease activity.
428 patients were included. 188 patients were in active disease, and 240 patients were in inactive disease at baseline. Elevation of ESR, hsCRP, and IL-6 were associated with active disease at baseline and during follow-up. Cox regression and Kaplan-Meier analysis showed that lower possibility and longer time to remission were associated with elevated ESR (hazard ratio [HR] = 0.32, 80 vs 33 weeks, p < 0.001), hsCRP (HR = 0.45, 70 vs 31 weeks, p < 0.001), and IL-6 (HR = 0.54, 66 vs 34 weeks, p < 0.01) in patients with active disease at baseline, while higher risk and shorter time for relapse were associated with elevated ESR (HR = 2.1, 59 vs 111 weeks, p < 0.001), hsCRP (HR = 2.1, 79 vs 113 weeks, p < 0.001), IL-6 (HR = 2.5, 64 vs 117 weeks, p < 0.001), and TNFα (HR = 2.7, 65 vs 114 weeks, p < 0.001) in patients with inactive disease at baseline.
Elevated ESR, CRP, and IL-6 are associated with active disease, lower possibility, and longer time to achieve disease remission. Elevation of any among ESR, CRP, IL-6, and TNFα is associated with high risk and short time for relapse during follow-up.
在一个随访队列中研究血液生物标志物与大动脉炎（TAK）疾病活动度之间的关联。
通过临床表现和重复的血管多普勒检查评估疾病活动度。采用逻辑回归和生存分析来分析红细胞沉降率（ESR）、高敏C反应蛋白（hsCRP）、白细胞介素-6（IL-6）和肿瘤坏死因子-α（TNFα）的血清水平与疾病活动度之间的关联。采用Kaplan-Meier法估计累积缓解率曲线，采用对数秩检验进行组间比较，采用Cox回归估计这些参数对疾病活动度的风险比。
纳入428例患者。188例患者在基线时处于疾病活动期，240例患者在基线时处于疾病非活动期。ESR、hsCRP和IL-6升高与基线时及随访期间的疾病活动有关。Cox回归和Kaplan-Meier分析显示，基线时处于疾病活动期的患者，ESR升高（风险比[HR]=0.32，80周对33周，p<0.001）、hsCRP升高（HR=0.45，70周对31周，p<0.001）和IL-6升高（HR=0.54，66周对34周，p<0.01）与缓解可能性较低和缓解时间较长有关；而基线时处于疾病非活动期的患者，ESR升高（HR=2.1，59周对111周，p<0.001）、hsCRP升高（HR=2.1，79周对113周，p<0.001）、IL-6升高（HR=2.5，64周对117周，p<0.001）和TNFα升高（HR=2.7，65周对114周，p<0.001）与复发风险较高和复发时间较短有关。
ESR、CRP和IL-6升高与疾病活动、缓解可能性较低及缓解时间较长有关。ESR、CRP、IL-6和TNFα中任何一项升高与随访期间复发风险较高和复发时间较短有关。
