风湿

UCTD向SLE发展

作者:BortoluzziA等 翻译:北医三院张警丰 来源:中国风湿病公众论坛 日期:2017-08-30
导读

         前沿进展 | 皮疹、抗磷脂抗体阳性和浆膜炎提示UCTD向SLE发展

关键字:  UCTD | SLE 

        目的:本研究的目的是在一个规模较大的未分化结缔组织病(UCTD)的队列研究中判断系统性红斑狼疮国际协作组织(SLICC)2012系统性红斑狼疮(SLE)分类标准在疾病初期以及长达15年(1999-2013)的随访过程中的诊断价值,进而根据美国风湿病学会(ACR)1997和SLICC2012两个分类标准在判断其在UCTD至SLE转变过程中的价值。

        方法:本研究纳入符合Mosca等制定的UCTD诊断标准的患者。所有患者在诊断初期(T0)以及之后随访期间的3个不同的时间点,均应用SLICC2012 SLE分类标准进行重新判断并与ACR1997标准判断的结果进行对照。

        结果:共纳入329例患者。在诊断初期,即T0期,没有一例患者符合SLE/ACR标准,同期,有44例患者符合SLE/SLICC的SLE分类标准。在整个随访期中,另有23例患者符合了SLE/SLICC的分类标准,14例患者符合了ACR分类标准,这部分患者逐步有UCTD进展至SLE。急性或亚急性皮疹、抗磷脂抗体阳性和浆膜炎与进展至SLE呈相关性。

        结论:在本UCTD队列中,在疾病初期应用SLICC-SLE分类标准可以减少部分漏诊的SLE病例。在随访中,与ACR的分类标准相比,SLICC的分类标准可将部分诊断为UCTD的患者更正为SLE的诊断。

        附原文:Abstract:Objectives The objectives of this study were to analysethe performance of theSystemicLupusInternationalCollaborating Clinics (SLICC)2012classificationcriteriaforsystemiclupuserythematosus(SLE)in alargecohortofundifferentiatedconnectivetissuedisease(UCTD)population at onset of thediseaseand duringalong-termfollow-upof 15 years (1999-2013) and to evaluatethe transition from UCTD to SLE, according to American College of Rheumatology(ACR) 1997 andSLICC2012classificationcriteria. MethodsAcohortof patients who mettheclassificationcriteriaproposed by Mosca etal. forUCTD, were analysed.TheSLICC2012classificationcriteriafor SLE wereretrospectively applied to each patient at the time of the diagnosis (T0) and alsoperiodically re-applied and compared to ACR 1997criteriaat threedifferent time points in thefollow-up. Results 329 patients wereenrolled. According to inclusioncriteriaat T0 no patient met the SLE/ACRcriteria,whilst, retrospectively applying the SLE/SLICCcriteria,44 patients already satisfied this set ofcriteriafor SLE. Duringthefollow-up23 new patients reached theSLE/SLICCcriteriaand 14 patients met theACRcriteriawith a stable rate of progression to SLE over time.Acute or subacute skin rash, antiphospholipid antibody (aPL) positivity and serositiswere the variables correlated to theevolutionto SLE. Conclusions Inour UCTD population, the applicationofSLICCclassificationcriteriaforSLE atdiseaseonset allowed identification of a proportion ofotherwise missed SLE cases; duringfollow-up, and compared withACRcriteria,SLICCcriteriaexpanded the number ofpatients classifiable as SLE otherwise classified as UCTD.

        引自:Bortoluzzi A,Furini F,Campanaro F,Govoni M.ApplicationofSLICCclassificationcriteriainundifferentiatedconnectivetissuediseaseandevolutioninsystemiclupuserythematosus:analysisofalargemonocentriccohortwithalong-termfollow-up.Lupus.2017 May;26(6):616-622.

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