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Troponin I levels in systemic sclerosis patients with myocardial involvement 心肌受累的系统性硬化症患者的肌钙蛋白 I 水平
Pub Date : 2024-06-03 DOI: 10.1177/23971983241255550
E. Hoekstra, S. Liem, Saad Ahmed, Nivine Levarht, Cynthia M. Fehres, A. Giucă, N. Ajmone Marsan, Tom WJ Huizinga, J. D. de Vries-Bouwstra
Troponin I has been suggested as a more specific diagnostic biomarker for myocardial involvement in systemic sclerosis than the frequently used troponin T. The aim of this study is to evaluate the additive value of troponin I to detect myocardial involvement in systemic sclerosis. To this end, we evaluated the association between troponin I levels and myocardial involvement in systemic sclerosis patients. A cross-sectional observational study was performed, including 20 healthy controls and four groups of each 20 systemic sclerosis patients from the Leiden Combined Care in Systemic Sclerosis cohort: (1) patients with myocardial involvement, (2) patients with myositis, (3) patients with elevated troponin T and creatine kinase levels but without organ involvement, and (4) patients without any signs of organ involvement. Troponin I levels were measured using enzyme-linked immunosorbent assay. Troponin I levels were compared between the different groups using the Mann–Whitney U and Kruskal–Wallis tests. The mean age of the 80 included patients was 56 years; 61% of the study population was female. Troponin I levels were not significantly different between patients with and without myocardial involvement (2.7 (0.5–15.3) vs 1.2 (0.1–6.6) ng/L; p = 0.117). Systemic sclerosis patients were more often positive for troponin I than healthy controls (70.0% vs 30.0%; p = 0.001). Elevated troponin I was not of additional value to diagnose myocardial involvement in systemic sclerosis patients.
与常用的肌钙蛋白 T 相比,肌钙蛋白 I 被认为是诊断系统性硬化症心肌受累的更具特异性的生物标志物。这项研究的目的是评估肌钙蛋白 I 在检测系统性硬化症心肌受累方面的附加价值。为此,我们评估了肌钙蛋白 I 水平与系统性硬化症患者心肌受累之间的关联。我们进行了一项横断面观察研究,其中包括 20 名健康对照者和莱顿系统性硬化症联合护理队列中的四组系统性硬化症患者,每组 20 人:(1) 心肌受累患者;(2) 肌炎患者;(3) 肌钙蛋白 T 和肌酸激酶水平升高但无器官受累的患者;(4) 无任何器官受累迹象的患者。肌钙蛋白 I 水平采用酶联免疫吸附测定法进行测量。采用 Mann-Whitney U 检验和 Kruskal-Wallis 检验比较不同组别之间的肌钙蛋白 I 水平。80 名患者的平均年龄为 56 岁,61% 为女性。有心肌受累和无心肌受累患者的肌钙蛋白 I 水平无明显差异(2.7 (0.5-15.3) vs 1.2 (0.1-6.6) ng/L;p = 0.117)。系统性硬化症患者的肌钙蛋白 I 阳性率高于健康对照组(70.0% vs 30.0%;p = 0.001)。肌钙蛋白 I 升高对诊断系统硬化症患者心肌受累没有额外价值。
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引用次数: 0
Prevalence, causes, and clinical associations of anemia in patients with systemic sclerosis: A cohort study 系统性硬化症患者贫血的患病率、原因和临床关联:一项队列研究
Pub Date : 2024-03-26 DOI: 10.1177/23971983241238921
Benoit Gachet, M. Jouvray, V. Koether, A. Collet, S. Morell-Dubois, S. Sanges, V. Sobanski, E. Hachulla, David Launay
Anemia is considered a risk factor of severity in systemic sclerosis. Yet, limited data are available on the frequency and causes of anemia in systemic sclerosis. The objectives of our study were to determine the frequency and causes of anemia in systemic sclerosis, to analyze the clinical and biological characteristics of patients with anemia, and to assess the association between anemia and systemic sclerosis prognosis. We conducted a prospective single-center study from January 2017 to May 2022. Patients underwent a hemoglobin assay and a standardized etiological workup to determine the causes of anemia at the initial visit. Clinical and biological parameters were compared between patients with anemia and those with normal hemoglobin levels. We followed up patients until May 2023 and compared their survival. A total of 502 systemic sclerosis patients, including 107 diffuse cutaneous systemic sclerosis, were included. At enrollment, 100 patients had anemia. The primary cause of anemia was iron deficiency (40%). Among the 32 patients with iron deficiency-associated anemia who underwent gastrointestinal exploration, 56% had digestive bleeding, with upper gastrointestinal tract involvement being the main cause (90%). Patients with anemia at enrollment had higher systemic sclerosis severity scores and more gastrointestinal symptoms compared to patients without anemia (p < 0.05). They exhibited higher systolic pulmonary artery pressure, lower anemia-corrected diffusing capacity for carbon monoxide, and lower forced vital capacity (p < 0.05). During follow-up, 65 patients (14.8%) died. After adjusting for age, systemic sclerosis subtypes, forced vital capacity, and pulmonary arterial hypertension, anemia at inclusion was associated with a higher mortality rate (hazard ratio: 1.94 (95% confidence interval: 1.39–2.48), p = 0.02). Our study shows a high frequency of anemia among patients with systemic sclerosis. Most anemias are due to iron deficiency, and gastrointestinal exploration can identify bleeding in the majority of the cases. In addition, our study confirms that systemic sclerosis patients with anemia have a more severe disease and a higher mortality rate.
贫血被认为是系统性硬化症病情严重的一个风险因素。然而,关于系统性硬化症患者贫血的频率和原因的数据却很有限。我们的研究旨在确定系统性硬化症患者贫血的频率和原因,分析贫血患者的临床和生物学特征,并评估贫血与系统性硬化症预后之间的关联。我们于2017年1月至2022年5月开展了一项前瞻性单中心研究。患者在初诊时接受血红蛋白检测和标准化病因检查,以确定贫血的原因。我们比较了贫血患者和血红蛋白水平正常患者的临床和生物参数。我们对患者进行了随访,直至 2023 年 5 月,并比较了他们的存活率。共纳入 502 名系统性硬化症患者,其中包括 107 名弥漫性皮肤系统性硬化症患者。入组时,100 名患者患有贫血。贫血的主要原因是缺铁(40%)。在 32 名接受胃肠道检查的缺铁性贫血患者中,56% 有消化道出血,上消化道受累是主要原因(90%)。与无贫血患者相比,入院时有贫血的患者系统性硬化严重程度评分更高,胃肠道症状更多(P < 0.05)。他们的肺动脉收缩压较高,贫血校正后的一氧化碳弥散能力较低,用力肺活量也较低(P < 0.05)。在随访期间,65 名患者(14.8%)死亡。在对年龄、系统性硬化症亚型、强迫生命容量和肺动脉高压进行调整后,纳入时贫血与较高的死亡率相关(危险比:1.94(95% 置信区间:1.39-2.48),P = 0.02)。我们的研究表明,系统性硬化症患者贫血的发生率很高。大多数贫血是由于缺铁引起的,而胃肠道检查可以发现大多数病例有出血现象。此外,我们的研究还证实,患有贫血症的系统性硬化症患者病情更严重,死亡率更高。
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引用次数: 0
Attitudes and barriers to pulmonary arterial hypertension screening in systemic sclerosis patients: A survey of UK-based rheumatologists 系统性硬化症患者对肺动脉高压筛查的态度和障碍:对英国风湿病学家的调查
Pub Date : 2024-03-13 DOI: 10.1177/23971983241235708
María Paula Álvarez-Hernández, Y. Allanore, Ivo Andrade, Maya H Buch, Gerry Coghlan, F. del Galdo, C. Denton, Dinesh Khanna, D. Kiely, John D Pauling, Sheila Ramjug, Michael Hughes
The objectives were to explore rheumatologists’ current clinical screening practices of pulmonary arterial hypertension in patients with systemic sclerosis in the United Kingdom and to identify barriers to screening and consider potential solutions. A survey of 31 questions was developed and included six sections: clinician demographics, the importance of screening, screening practices, barriers to screening, treatment and patient education. The survey was disseminated among rheumatologists working in the United Kingdom. Forty-four rheumatologists working in the United Kingdom participated in the study, and the majority completed all the questions. Around one-third (37.0%) worked in specialised systemic sclerosis units (university or general hospitals (54.5% and 45.4%, respectively)). The majority recognised that systemic sclerosis-pulmonary arterial hypertension is a major cause of morbidity and mortality. Over half (60.0%) reported using the DETECT algorithm to screen for systemic sclerosis-pulmonary arterial hypertension, although other algorithms were also sometimes used. All of the respondents utilised transthoracic echocardiogram, and almost all (95.0%) performed pulmonary function tests for screening purposes. Various challenges and barriers were identified relating to systemic sclerosis-pulmonary arterial hypertension screening, with the difficulty in interpreting results from other hospitals and extended wait times for diagnostic tests being the most reported (76.0% and 74.0%, respectively). Most respondents agreed that access to key investigations (87.0%), ongoing clinician education (82.0%), multidisciplinary meetings (79.5%) and a better understanding of proposed screening algorithms (79.5%) could be potential solutions. Screening patients with systemic sclerosis for pulmonary arterial hypertension is crucial to improve survival, but variable practices exist among UK rheumatologists. Solutions include educating healthcare professionals on guidelines, sharing information between centres and integrating care services.
研究目的是探索英国风湿病学家目前对系统性硬化症患者肺动脉高压的临床筛查方法,找出筛查障碍并考虑潜在的解决方案。该调查包含 31 个问题,包括六个部分:临床医生人口统计学、筛查的重要性、筛查方法、筛查障碍、治疗和患者教育。该调查在英国的风湿免疫科医生中进行了传播。44 名在英国工作的风湿病学家参与了这项研究,其中大多数人完成了所有问题。约三分之一(37.0%)的人在系统性硬化症专科医院(大学医院或综合医院,分别占 54.5% 和 45.4%)工作。大多数人认识到系统性硬化症-肺动脉高压是发病和死亡的主要原因。半数以上(60.0%)的受访者表示使用 DETECT 算法筛查系统性硬化-肺动脉高压,但有时也会使用其他算法。所有受访者都使用了经胸超声心动图,几乎所有受访者(95.0%)都为筛查目的进行了肺功能测试。受访者指出了系统性硬化症-肺动脉高压筛查所面临的各种挑战和障碍,其中报告最多的是难以解释其他医院的结果和诊断检测等待时间过长(分别为 76.0% 和 74.0%)。大多数受访者认为,获得关键检查(87.0%)、持续的临床医生教育(82.0%)、多学科会议(79.5%)和更好地理解建议的筛查算法(79.5%)可能是潜在的解决方案。为系统性硬化症患者筛查肺动脉高压对提高生存率至关重要,但英国风湿病学家的做法各不相同。解决方案包括对医护人员进行指南教育、在各中心之间共享信息以及整合护理服务。
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引用次数: 0
Resilience partially mediates the association between perceived social isolation and life satisfaction in people with systemic sclerosis 复原力部分调节了系统性硬化症患者感知到的社会孤立与生活满意度之间的关系
Pub Date : 2024-03-05 DOI: 10.1177/23971983241232853
Y. T. Chen, A. Hassett, Dinesh Khanna, Susan L Murphy
Systemic sclerosis (SSc) negatively affects quality of life, yet the factors influencing life satisfaction, a key aspect of well-being, remain unclear in this population. Social isolation is common in SSc, potentially linked to decreased life satisfaction, but the underlying mechanisms are unexplored. Resilience, a modifiable psychological resource, may act as a mediator in this relationship among people with SSc. This study aimed to examine the relationship between perceived social isolation and life satisfaction and to investigate whether resilience mediates this relationship. The Patient-Reported Outcomes Measurement Information System Social Isolation Short Form, the Connor-Davidson Resilience Scale, and the Satisfaction with Life Scale were used to assess perceived social isolation, resilience, and life satisfaction. Linear regressions were conducted using the PROCESS macro for SPSS. Among 163 individuals with SSc who provided complete data at baseline (mean age = 54.7 ± 11.9 years), 47% had diffuse cutaneous SSc, and 57% had an early disease duration. Perceived social isolation was negatively associated with life satisfaction. Resilience partially mediated the association between perceived social isolation and life satisfaction in people with SSc. Findings revealed a significant association between perceived social isolation and life satisfaction and the mediating role of resilience in this association among people with SSc. Results suggest resilience may act as a protective mediator, counteracting the negative influence of perceived social isolation on life satisfaction. Findings support the promotion of social connection and resilience to enhance life satisfaction in people with SSc. NCT04908943
系统性硬化症(SSc)会对生活质量产生负面影响,但影响生活满意度(幸福感的一个重要方面)的因素在这一人群中仍不明确。社会隔离在系统性硬化症患者中很常见,可能与生活满意度下降有关,但其潜在机制尚未探明。复原力作为一种可改变的心理资源,可能会在 SSc 患者的这种关系中起到中介作用。本研究旨在探讨感知到的社会隔离与生活满意度之间的关系,并研究复原力是否能调节这种关系。研究采用患者报告结果测量信息系统社会隔离简表、康纳-戴维森复原力量表和生活满意度量表来评估感知到的社会隔离、复原力和生活满意度。使用 SPSS 的 PROCESS 宏进行线性回归。在基线时提供完整数据的 163 名 SSc 患者(平均年龄为 54.7 ± 11.9 岁)中,47% 患有弥漫性皮肤 SSc,57% 病程较早。感知到的社会隔离与生活满意度呈负相关。复原力部分调节了SSc患者感知到的社会隔离与生活满意度之间的关系。研究结果表明,在 SSc 患者中,感知到的社会隔离与生活满意度之间存在重要关联,而复原力在这种关联中起着中介作用。研究结果表明,抗逆力可以作为一种保护性中介,抵消感知到的社会隔离对生活满意度的负面影响。研究结果支持促进社会联系和复原力以提高 SSc 患者的生活满意度。NCT04908943
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引用次数: 0
WSO Author Index WSO 作者索引
Pub Date : 2024-03-01 DOI: 10.1177/23971983241229600
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引用次数: 0
Oral abstracts 口头摘要
Pub Date : 2024-03-01 DOI: 10.1177/23971983231224122
{"title":"Oral abstracts","authors":"","doi":"10.1177/23971983231224122","DOIUrl":"https://doi.org/10.1177/23971983231224122","url":null,"abstract":"","PeriodicalId":506053,"journal":{"name":"Journal of Scleroderma and Related Disorders","volume":"55 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140272773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Assessing hand and global disability in a cohort of Algerian patients with systemic sclerosis: Construct validities of the Arab Hand Function Index and the Arabic Health Assessment Questionnaire 评估阿尔及利亚系统性硬化症患者的手部和全身残疾情况:阿拉伯手功能指数和阿拉伯健康评估问卷的结构有效性
Pub Date : 2024-02-28 DOI: 10.1177/23971983241231082
N. Benmostefa, Rachid Malek, Marie Robert, B. Chaigne, Samy Slimani, Samir Rouabhia, Daoud Roula, Mallem Djamel, L. Mouthon
The study aimed to assess the construct validity of the Arab Hand Function Index and the Arabic Health Assessment Questionnaire in Algerian patients with systemic sclerosis. Consecutive Algerian patients who fulfilled the American College of Rheumatology/European League Against Rheumatism criteria for systemic sclerosis were included. In addition to disease characteristics, global disability and hand disability were assessed using the Arabic Health Assessment Questionnaire and the Arab Hand Function Index, respectively. Construct validity was assessed by convergent and divergent validity (Spearman’s rank correlation coefficient) and factor analysis. The scale reliability was assessed using the Cronbach’s alpha. We evaluated 100 systemic sclerosis patients (83 females) of mean ± standard deviation age 46.7 ± 12.3 years, including 59 limited cutaneous systemic sclerosis and 41 diffuse cutaneous systemic sclerosis. Raynaud’s phenomenon was detected in 99 patients and digital ulcers in 25. Gastrointestinal tract involvement and interstitial lung disease were detected in 86/100 (86%) and 46/72 (63.9%) patients, respectively. Anti-topoisomerase I and anti-centromere antibodies were detected in 33/76 (43.4%) and 23/76 (30.3%) patients, respectively. The Arab Hand Function Index had a good construct validity with a total score explaining 61% of the variance of the Arabic Health Assessment Questionnaire which also had a good construct validity. Factor analysis of the Arab Hand Function Index and the Arabic Health Assessment Questionnaire items extracted two factors explaining 64% of the variance for the Arab Hand Function Index and one factor explaining 55% of the variance for the Arabic Health Assessment Questionnaire. The Arab Hand Function Index and the Arabic Health Assessment Questionnaire were reliable questionnaires with a Cronbach’s alpha >0.8. In Algerian patients with systemic sclerosis, Arab Hand Function Index and Arabic Health Assessment Questionnaire have a good construct validity and reliability.
该研究旨在评估阿拉伯手功能指数和阿拉伯健康评估问卷在阿尔及利亚系统性硬化症患者中的构建有效性。研究对象包括符合美国风湿病学会/欧洲抗风湿病联盟系统性硬化症标准的阿尔及利亚患者。除疾病特征外,还分别使用阿拉伯健康评估问卷和阿拉伯手部功能指数对全身残疾和手部残疾进行了评估。结构效度通过收敛效度、发散效度(斯皮尔曼等级相关系数)和因子分析进行评估。量表信度采用 Cronbach's alpha 进行评估。我们评估了 100 名系统性硬化症患者(83 名女性),平均年龄(标准差)为 46.7 ± 12.3 岁,其中包括 59 名局限性皮肤系统性硬化症患者和 41 名弥漫性皮肤系统性硬化症患者。99 名患者出现雷诺现象,25 名患者出现数字溃疡。86/100(86%)和46/72(63.9%)名患者分别患有胃肠道受累和间质性肺病。33/76(43.4%)和 23/76(30.3%)名患者分别检测到抗拓扑异构酶 I 和抗中心粒抗体。阿拉伯手功能指数具有良好的构建效度,其总分可解释阿拉伯健康评估问卷 61% 的方差,而阿拉伯健康评估问卷也具有良好的构建效度。对阿拉伯手功能指数和阿拉伯语健康评估问卷项目进行因子分析,提取出两个因子,解释了阿拉伯手功能指数 64% 的方差,提取出一个因子,解释了阿拉伯语健康评估问卷 55% 的方差。阿拉伯手部功能指数和阿拉伯健康评估问卷是可靠的问卷,Cronbach's alpha >0.8。在阿尔及利亚系统性硬化症患者中,阿拉伯手部功能指数和阿拉伯健康评估问卷具有良好的建构效度和可靠性。
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引用次数: 0
Perception of aesthetic impairment in patients with systemic sclerosis determined using a semi-quantitative scale and its association with disease characteristics 使用半定量量表确定系统性硬化症患者对美学损害的感知及其与疾病特征的关系
Pub Date : 2024-02-27 DOI: 10.1177/23971983241231620
M. Farhat, Pierre Guerreschi, S. Morell-Dubois, Valérie Deken, Julien Labreuche, S. Sanges, V. Sobanski, E. Hachulla, Olivier Cottencin, David Launay
Systemic sclerosis is a fibrotic disease. Body image assessments could be key in optimizing care; however, data are scarce. The main objective was to assess the perception of aesthetic impairment using a visual aesthetic evaluation scale in patients with systemic sclerosis compared with healthy subjects. The secondary objectives were to assess associations between the perception of aesthetic impairment and scores on standardized questionnaires for aesthetic impairment as well as clinical, psychological/quality of life, and functional parameters of patients with systemic sclerosis. This study evaluated and compared the perception of aesthetic impairment in two populations: patients with systemic sclerosis from a referral center at Lille Hospital, France, and healthy controls. This study included 88 patients (69 (78.4%) women) with a median age of 52 years and 88 controls (49 (55.7%) women) with a median age of 45 years. The perception of aesthetic impairment assessed using the aesthetic evaluation scale was poorer in systemic sclerosis patients than in controls (3.7 ± 0.3 vs 2.8 ± 0.3, p = 0.028) and was statistically correlated with assessments using the adapted satisfaction with appearance, a specific aesthetic impact assessment questionnaire for patients with systemic sclerosis. Patients with anxiety or depressive symptoms had significantly higher aesthetic evaluation scale scores. Systemic sclerosis patients with facial involvement and pitting scars had a worse perception of aesthetic impairment. Compared with healthy controls, systemic sclerosis patients had a worse perception of aesthetic impairment, especially systemic sclerosis patients with anxiety or depression and those with facial and hand involvement. The aesthetic evaluation scale appears to be an easy-to-use tool to evaluate body image. Correlations of the aesthetic evaluation scale score with psychological and quality of life parameters reflect the importance of these parameters for body image evaluation and its complex assessment. Clinical Trial NCT03271320 (Registered 9 January 2017, https://www.clinicaltrials.gov/ct2/show/NCT03271320?term=NCT03271320&cntry=FR&draw=2&rank=1 ).
系统性硬化症是一种纤维化疾病。身体形象评估可能是优化护理的关键;然而,这方面的数据却很少。研究的主要目的是使用视觉美学评价量表评估系统性硬化症患者与健康人相比对美学损伤的感知。次要目标是评估系统性硬化症患者对审美障碍的感知与审美障碍标准化问卷得分之间的关联,以及患者的临床、心理/生活质量和功能参数。这项研究评估并比较了两类人群对审美障碍的感知:法国里尔医院转诊中心的系统性硬化症患者和健康对照组。这项研究包括 88 名患者(69 名(78.4%)女性)和 88 名对照组患者(49 名(55.7%)女性),前者的中位年龄为 52 岁,后者的中位年龄为 45 岁。与对照组相比,系统性硬化症患者使用美学评价量表评估的美学损伤感知较差(3.7 ± 0.3 vs 2.8 ± 0.3,p = 0.028),并且与使用经调整的外观满意度评估结果在统计学上存在相关性,后者是针对系统性硬化症患者的特定美学影响评估问卷。有焦虑或抑郁症状的患者的美学评估量表得分明显更高。面部受累和有点状疤痕的系统性硬化症患者对美学损害的感知更差。与健康对照组相比,系统性硬化症患者对美学损害的感知更差,尤其是伴有焦虑或抑郁症状以及面部和手部受累的系统性硬化症患者。美学评估量表似乎是一种易于使用的身体形象评估工具。美学评价量表得分与心理和生活质量参数的相关性反映了这些参数对身体形象评价及其复杂评估的重要性。临床试验NCT03271320(2017年1月9日注册,https://www.clinicaltrials.gov/ct2/show/NCT03271320?term=NCT03271320&cntry=FR&draw=2&rank=1 )。
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引用次数: 0
Helicobacter pylori in gastrointestinal manifestation of systemic sclerosis 幽门螺杆菌在系统性硬化症胃肠道表现中的作用
Pub Date : 2024-02-19 DOI: 10.1177/23971983241227133
J. Raja, Shanthini Muthusamy, Choung Min Ng, S. Mahadeva
To study the prevalence of Helicobacter pylori in systemic sclerosis patients and its gastrointestinal manifestations in comparison with Helicobacter pylori-negative systemic sclerosis patients. Systemic sclerosis gastrointestinal outcome post Helicobacter pylori eradication was evaluated. In total, 70 systemic sclerosis patients and 70 age-, gender- and race-matched healthy controls had their urea breath test done. Gastrointestinal manifestations in systemic sclerosis were assessed using University of California at Los Angeles 2.0 and Leeds Dyspepsia Questionnaire questionnaires. Systemic sclerosis patients with confirmed Helicobacter pylori infection were given standard Helicobacter pylori eradication therapy. Urea breath test was repeated 6 weeks posteradication therapy with their gastrointestinal symptoms reassessed. The prevalence of Helicobacter pylori was low in both systemic sclerosis patients (10%) and healthy controls (2.9%). There was no significant difference in gastrointestinal symptoms between Helicobacter pylori-positive and Helicobacter pylori-negative systemic sclerosis patients. However, the Helicobacter pylori-positive patients reported higher median severity scores for the gastrointestinal symptoms of reflux (0.5 vs 0.35), abdominal distension (1.5 vs 0.75) and social functioning impairment score (0.5 vs 0.16) using the University of California at Los Angeles 2.0 score. The Helicobacter pylori-positive patients also indicated increased upper abdominal pain (3.0 vs 0.0), regurgitation (2.0 vs 0.0) and burping (3.0 vs 0.0), observed from the Leeds Dyspepsia Questionnaire scores. Gastrointestinal outcomes post- Helicobacter pylori eradication showed either an improvement or complete resolution of symptoms. Gastrointestinal symptoms in systemic sclerosis patients are unlikely to be caused by Helicobacter pylori in the recent years in our cohort of patients. No significant difference in gastrointestinal symptoms was seen between Helicobacter pylori-positive and Helicobacter pylori-negative systemic sclerosis patients. Helicobacter pylori can be readily tested by urea breath test to look for present infection.
与幽门螺旋杆菌阴性的系统性硬化症患者相比,研究幽门螺旋杆菌在系统性硬化症患者中的感染率及其胃肠道表现。评估根除幽门螺旋杆菌后系统性硬化症患者的胃肠道表现。共有 70 名系统性硬化症患者和 70 名年龄、性别和种族匹配的健康对照者接受了尿素呼气试验。使用加利福尼亚大学洛杉矶分校 2.0 和利兹消化不良问卷评估了系统性硬化症的胃肠道表现。对确诊感染幽门螺旋杆菌的系统性硬化症患者进行了标准的幽门螺旋杆菌根除治疗。在接受根除治疗 6 周后再次进行尿素呼气试验,并重新评估他们的胃肠道症状。幽门螺旋杆菌在系统性硬化症患者(10%)和健康对照组(2.9%)中的感染率都很低。幽门螺旋杆菌阳性和幽门螺旋杆菌阴性的系统性硬化症患者在胃肠道症状方面没有明显差异。不过,幽门螺旋杆菌阳性患者的胃肠道症状反流(0.5 对 0.35)、腹胀(1.5 对 0.75)和社会功能障碍(0.5 对 0.16)的中位数严重程度评分(采用加利福尼亚大学洛杉矶分校 2.0 评分标准)较高。根据利兹消化不良问卷评分,幽门螺杆菌阳性患者的上腹部疼痛(3.0 对 0.0)、反胃(2.0 对 0.0)和打嗝(3.0 对 0.0)也有所增加。根除幽门螺杆菌后的胃肠道结果显示症状有所改善或完全消失。近年来,在我们的患者队列中,系统性硬化症患者的胃肠道症状不太可能由幽门螺旋杆菌引起。幽门螺旋杆菌阳性和幽门螺旋杆菌阴性的系统性硬化症患者在胃肠道症状方面没有明显差异。幽门螺旋杆菌可通过尿素呼气试验来检测是否存在感染。
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引用次数: 0
Practice pattern for the use of intravenous iloprost for the treatment of peripheral vasculopathy in systemic sclerosis: A case–control study from the Italian national multicenter “SPRING” (Systemic Sclerosis Progression InvestiGation) Registry 使用静脉注射伊洛前列素治疗系统性硬化症外周血管病变的实践模式:意大利国家多中心 "SPRING"(系统性硬化症进展调查)登记处的病例对照研究
Pub Date : 2024-01-11 DOI: 10.1177/23971983231209809
V. Riccieri, G. Pellegrino, E. Cipolletta, D. Giuggioli, G. Bajocchi, S. Bellando-Randone, L. Dagna, G. Zanframundo, Rosario Foti, F. Cacciapaglia, G. Cuomo, A. Ariani, E. Rosato, G. Lepri, F. Girelli, E. Zanatta, S. Bosello, I. Cavazzana, F. Ingegnoli, M. De Santis, G. Murdaca, G. Abignano, N. Romeo, A. Della Rossa, Maurizio Caminiti, A. Iuliano, G. Ciano, L. Beretta, G. Bagnato, E. Lubrano, I. de Andres, A. Giollo, M. Saracco, C. Agnes, F. Lumetti, A. Spinella, Luca Magnani, C. Campochiaro, G. de Luca, V. Codullo, E. Visalli, C. Di Vico, A. Gigante, F. Saccon, Maria Grazia Lazzaroni, F. Franceschini, E. Generali, G. Mennillo, S. Barsotti, G. Pagano Mariano, Francesca Calabrese, F. Furini, Licia Vultaggio, S. Parisi, C. Peroni, Gerolamo Bianchi, Fabrizio Conti, Franco Cozzi, Salvatore D'Angelo, Andrea Doria, E. Fusaro, M. Govoni, S. Guiducci, F. Iannone, C. Salvarani, G. Sebastiani, C. Ferri, M. Matucci-Cerinic, R. De Angelis
Intravenous iloprost has been widely used for the treatment of systemic sclerosis peripheral vasculopathy. No agreement has been found on the regimen and the dosage of intravenous iloprost in different scleroderma subset conditions. This study aimed to evaluate the modalities of intravenous iloprost administration within a large cohort of systemic sclerosis patients from the SPRING Registry and to identify any associated clinical-demographic, instrumental or therapeutic data. Data of systemic sclerosis patients treated with intravenous iloprost for at least 1 year (case group) were retrospectively analyzed, including different timing and duration of intravenous iloprost session, and compared with those of untreated patients (control group). Out of 1895 analyzed patients, 937 (49%) received intravenous iloprost treatment, while 958 (51%) were assigned to the control group. Among cases, about 70% were treated every 4 weeks, 24% with an interval of more than 4 weeks, and only 6% of less than 4 weeks. Most patients receiving the treatment every 4 weeks, or less, underwent infusion cycle for 1 day only, while if it was scheduled with an interval of more than 4 weeks, a total number of 5 consecutive days of infusions was the preferred regimen. The comparison between the two groups revealed that patients treated with intravenous iloprost had a higher frequency of DUs (p < 0.001), pitting scars (p < 0.001), diffuse cutaneous involvement (p < 0.001), interstitial lung disease (p < 0.002), as well as higher rates of anti-topoisomerase I, “ late” scleroderma pattern at nailfold videocapillaroscopy. These findings were confirmed by multivariate analysis. Our data provide a picture on the Italian use of intravenous iloprost among systemic sclerosis patients and showed that it was usually employed in patients with a more aggressive spectrum of the disease. The disparity of intravenous iloprost treatment strategies in the different centers suggests the need of a rational therapeutical approach based on the clinical characteristics of different patients’ subsets.
静脉注射伊洛前列素被广泛用于治疗系统性硬化症外周血管病变。在不同的硬皮病亚型中,静脉注射伊洛前列素的方案和剂量尚未达成一致。本研究旨在评估来自 SPRING 登记处的一大批系统性硬化症患者静脉注射伊洛前列素的方式,并确定任何相关的临床-人口学、器械或治疗数据。研究人员回顾性分析了接受静脉注射伊洛前列素治疗至少一年的系统性硬化症患者(病例组)的数据,包括静脉注射伊洛前列素的不同时间和持续时间,并与未接受治疗的患者(对照组)的数据进行了比较。在分析的 1895 例患者中,937 例(49%)接受了静脉注射伊洛前列素治疗,958 例(51%)被分配到对照组。在病例中,约 70% 的患者每 4 周接受一次治疗,24% 的患者间隔超过 4 周,只有 6% 的患者间隔少于 4 周。大多数患者每 4 周或更短时间接受一次治疗,输液周期仅为 1 天,而如果治疗间隔超过 4 周,则首选连续输液 5 天的治疗方案。两组患者的比较结果显示,接受静脉注射伊洛前列素治疗的患者出现 DUs(p < 0.001)、点状疤痕(p < 0.001)、弥漫性皮肤受累(p < 0.001)、间质性肺病(p < 0.002)的频率更高,而且甲襞视频硬皮镜检查中出现抗拓扑异构酶 I、"晚期 "硬皮病模式的比例更高。多变量分析证实了这些发现。我们的数据提供了意大利系统性硬化症患者静脉注射伊洛前列素的情况,并显示该药物通常用于病情较重的患者。不同中心在静脉注射伊洛前列素治疗策略上的差异表明,需要根据不同患者的临床特征采取合理的治疗方法。
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Journal of Scleroderma and Related Disorders
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