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雷诺现象在系统性红斑狼疮中的临床意义。

Clinical Significance of Raynaud Phenomenon in Systemic Lupus Erythematosus.

机构信息

From the McGill University Health Center.

Lady Davis Institute for Medical Research, Montreal, Quebec, Canada.

出版信息

J Clin Rheumatol. 2022 Mar 1;28(2):e488-e490. doi: 10.1097/RHU.0000000000001773.

Abstract

OBJECTIVE

There are limited reports of the clinical significance of Raynaud phenomenon (RP) in systemic lupus erythematosus (SLE), with some suggesting RP is associated with less severe lupus. Since most prior studies were small and/or focused on a specific race/ethnic demographic, it is unclear if those results are generalizable. We evaluated whether RP was associated with demographic and clinical factors in a large multiethnic SLE cohort.

METHODS

We studied Montreal General Hospital SLE cohort patients who are followed with standardized annual assessments. We included patients with at least 1 visit across 2011-2018 and assessed demographic and clinical variables (using the 1997 American College of Rheumatology criteria and the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index) at their first visit. We present multivariate logistics regression analyses of cross-sectional associations between these variables and RP in SLE.

RESULTS

Of 489 SLE patients, most were female (n = 445, 91%). Mean age at SLE diagnosis was 31.5 (standard deviation, 13.5) years, and 169 (34.6%) had RP. In our fully adjusted model, female sex (odds ratio [OR], 2.43; 95% confidence interval [CI], 1.07-6.03), White race/ethnicity (OR, 1.85; 95% CI, 1.10-3.17), neurological/neuropsychiatric manifestations (OR, 1.98; 95% CI, 1.10-3.56), and anti-RNP antibodies (OR, 3.03; 95% CI, 1.73-5.38) were positively associated with RP, whereas hemolytic anemia and cellular casts were negatively associated.

CONCLUSIONS/DISCUSSION: Over one third of our large multiethnic North American SLE cohort had RP. This study confirmed associations between RP and a specific SLE phenotype.

摘要

目的

红斑性肢痛症(RP)在系统性红斑狼疮(SLE)中的临床意义有限,有研究表明 RP 与狼疮病情较轻有关。由于之前的大多数研究规模较小且/或仅针对特定种族/民族人群,因此尚不清楚这些结果是否具有普遍性。我们评估了 RP 是否与大型多民族 SLE 队列中的人口统计学和临床因素有关。

方法

我们研究了在 2011-2018 年期间至少有一次就诊记录的蒙特利尔总医院 SLE 队列患者,并对其首次就诊时的人口统计学和临床变量(采用 1997 年美国风湿病学会标准和系统性红斑狼疮国际合作临床/美国风湿病学会损害指数)进行评估。我们呈现了这些变量与 SLE 中 RP 之间的横断面关联的多变量逻辑回归分析。

结果

在 489 例 SLE 患者中,大多数为女性(n = 445,91%)。SLE 诊断时的平均年龄为 31.5(标准差,13.5)岁,有 169 例(34.6%)患有 RP。在我们的完全调整模型中,女性(比值比 [OR],2.43;95%置信区间 [CI],1.07-6.03)、白人种族/民族(OR,1.85;95% CI,1.10-3.17)、神经/神经精神表现(OR,1.98;95% CI,1.10-3.56)和抗 RNP 抗体(OR,3.03;95% CI,1.73-5.38)与 RP 呈正相关,而溶血性贫血和细胞管型与 RP 呈负相关。

结论/讨论:我们的大型多民族北美 SLE 队列中超过三分之一的患者有 RP。本研究证实了 RP 与特定的 SLE 表型之间的关联。

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