Vollertsen R S, Conn D L, Ballard D J, Ilstrup D M, Kazmar R E, Silverfield J C
Medicine (Baltimore). 1986 Nov;65(6):365-75.
We describe the clinical and laboratory characteristics of 52 patients with rheumatoid vasculitis whose condition was diagnosed at a tertiary care center between 1974 and 1981, and we report their survival and the factors that were associated with decreased survival. The patients with rheumatoid vasculitis had decreased survival in comparison with an age-, sex-, and region-matched general population. Their survival was also decreased in comparison to that of an incidence cohort of community patients with rheumatoid arthritis. In the latter cohort, decreased survival was confined to those patients with classic but not definite rheumatoid arthritis. After partial correction for referral bias, we found no difference in survival between the cohort with rheumatoid vasculitis and the cohort with classic rheumatoid arthritis. We found that the age at diagnosis of rheumatoid vasculitis, the therapeutic decisions before and at diagnosis, and the referral distance were the best predictors of survival. Abnormal urinary sediment and hypergammaglobulinemia also predicted poor survival, but because of a lack of specificity in a small number of clinically abnormal values, we urge a cautious interpretation of their importance.
我们描述了1974年至1981年间在一家三级医疗中心确诊的52例类风湿性血管炎患者的临床和实验室特征，并报告了他们的生存率以及与生存率降低相关的因素。与年龄、性别和地区匹配的普通人群相比，类风湿性血管炎患者的生存率较低。与社区类风湿关节炎发病队列的患者相比，他们的生存率也较低。在后一组队列中，生存率降低仅限于那些患有典型而非明确类风湿关节炎的患者。在对转诊偏倚进行部分校正后，我们发现类风湿性血管炎队列和典型类风湿关节炎队列之间的生存率没有差异。我们发现，类风湿性血管炎的诊断年龄、诊断前和诊断时的治疗决策以及转诊距离是生存率的最佳预测因素。尿沉渣异常和高球蛋白血症也预示着生存率较差，但由于少数临床异常值缺乏特异性，我们敦促谨慎解读它们的重要性。
