风湿

RF是ANCA相关性血管炎病情活动的炎症标志物

作者:Watanabe S, et al. 译者:北医三院姚中强 来源:中国风湿病公众论坛 日期:2018-01-19
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         【前沿进展】RF是ANCA相关性血管炎病情活动的炎症标志物

关键字:  ANCA相关性血管炎 

        摘要 背景:有些ANCA相关性血管炎(AAV)患者也有类风湿因子(RF)阳性。然而AAV患者中其临床意义未明。本研究的目的是阐明AAV患者中存在RF与患者临床特点的相关性。结果:纳入47名不伴有类风湿关节炎的AAV的患者。我们比较了RF阳性亚组 (n=29)和RF阴性亚组 (n=18)患者的临床特点。 RF阳性AAV患者的伯明翰血管炎活动性评分(BVAS)比RF阴性组更高(P=0.026)。RF阳性患者CRP 和 ESR水平高于RF阴性组(其P值分别为P=0.020和P=0.007)。IgM型RF滴度与 BVAS评分显著相关 (r=0.50, P=0.0004)。而且 IgM-RF滴度与CRP 水平(r=0.41, P=0.004)和ESR水平 (r=0.39, P=0.016)、IgM (r=0.36, P=0.016)和IgG (r=0.37, P=0.015)水平均显著相关。RF阳性组患者开始透析治疗的比例、使用机械通气比例和死亡率均高于RF阴性亚组。结论:AAV患者中RF滴度与病情活动性显著相关,是其一种炎症标志物。AAV患者存在RF可作为一个预后差的指标。

        附原文:AbstractBACKGROUND:Some patients withantineutrophil cytoplasmic antibody (ANCA)-associatedvasculitis(AAV) alsohave positivity of rheumatoid factor (RF). However, the clinical significanceof this occurrence remains unknown in AAV patients. The aim of this study wasto clarify an association between the presence of RF and clinical features inpatients with AAV.RESULTS:Forty-seven patients diagnosed with AAV who were not complicated with RA were enrolled in this study. We compared clinicalmanifestations of AAV between an RF-positive subset (n=29) and anRF-negative subset (n=18). TheBirminghamVasculitisActivity Score (BVAS) was higher (P=0.026) in theRF-positive subset than in the RF-negative subset. The levels of CRP and ESRwere higher in the RF-positive patients (P=0.020 and P=0.007,respectively) compared to the RF-negative subset. IgM-RF titers weresignificantly correlated with the BVAS (r=0.50, P=0.0004). In addition, the IgM-RF titershad significant correlations with the levels of CRP (r=0.41, P=0.004), ESR (r=0.39, P=0.016), IgM (r=0.36, P=0.016) and IgG (r=0.37, P=0.015). Thefrequency of commencement of dialysis therapy, usage of mechanical ventilationand mortality were higher in the RF-positive subset than in the RF-negativesubset.CONCLUSIONS:Inpatients with AAV, RF titers were significantly correlated with diseaseactivity and the levels of inflammatory markers. The presence of RF could be apoor prognostic factor in patients with AAV.

        引自:Watanabe S,Gono T,Nishina K,Sugitani N,Watanabe E,Yabe H,Terai C.Rheumatoid factor is correlatedwith disease activity and inflammatory markers in antineutrophil cytoplasmicantibody-associatedvasculitis.BMC Immunol.2017 Dec20;18(1):53. doi: 10.1186/s12865-017-0234-8.

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