类风湿关节炎中与血管炎发生相关的因素：一项病例对照研究的结果
Factors associated with the development of vasculitis in rheumatoid arthritis: results of a case-control study.
作者信息
Voskuyl A E, Zwinderman A H, Westedt M L, Vandenbroucke J P, Breedveld F C, Hazes J M
机构信息
Department of Rheumatology, University Hospital, Leiden, Netherlands.
出版信息
Ann Rheum Dis. 1996 Mar;55(3):190-2. doi: 10.1136/ard.55.3.190.
OBJECTIVE
To investigate those characteristics of patients with rheumatoid arthritis (RA) that are associated with the development of rheumatoid vasculitis (RV).
METHODS
Demographic and clinical data of 69 patients who had been diagnosed as having RV were compared with those of 138 contemporaneous control patients with RA who were not suspected to have vasculitis. Vasculitis was confirmed histologically in 96% of the subjects with RV.
RESULTS
Variables associated with the development of RV were: 1) male gender, presence of increased serum concentrations of rheumatoid factor, joint erosions, subcutaneous nodules, number of disease modifying antirheumatic drugs previously prescribed, treatment (ever) with D-penicillamine or azathioprine; 2) presence of nail fold lesions and any other extrarticular feature one year before the time of diagnosis of RV; 3) treatment with corticosteroids at the time of diagnosis of RV.
CONCLUSIONS
The development of RV is associated with male gender, extra-articular features, and a severe course of RA as indicated by the presence of joint destruction and need for intensive treatment with antirheumatic drugs. The strongest association was found with the presence of increased concentrations of rheumatoid factor.
目的
研究类风湿关节炎（RA）患者中与类风湿血管炎（RV）发生相关的特征。
方法
将69例已确诊为RV的患者的人口统计学和临床数据与138例同期未怀疑有血管炎的RA对照患者的数据进行比较。96%的RV患者经组织学证实有血管炎。
结果
与RV发生相关的变量有：1）男性，类风湿因子血清浓度升高、关节侵蚀、皮下结节、既往开具的改善病情抗风湿药物数量、曾用D-青霉胺或硫唑嘌呤治疗；2）在RV诊断前一年出现甲襞病变及任何其他关节外表现；3）RV诊断时使用皮质类固醇治疗。
结论
RV的发生与男性、关节外表现以及RA的严重病程相关，关节破坏的存在和抗风湿药物强化治疗的需求表明了这一点。发现与类风湿因子浓度升高的关联最为密切。
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