当前位置: X-MOL 学术J. Autoimmun. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Alveolar haemorrhage in ANCA-associated vasculitis: Long-term outcome and mortality predictors.
Journal of Autoimmunity ( IF 7.9 ) Pub Date : 2020-01-09 , DOI: 10.1016/j.jaut.2019.102397
Luca Quartuccio 1 , Milena Bond 1 , Miriam Isola 2 , Sara Monti 3 , Mara Felicetti 4 , Federica Furini 5 , Stefano Murgia 6 , Alvise Berti 7 , Elena Silvestri 8 , Giulia Pazzola 9 , Enrica Bozzolo 10 , Pietro Leccese 11 , Bernd Raffeiner 12 , Simone Parisi 13 , Ilaria Leccese 14 , Francesco Cianci 15 , Silvano Bettio 16 , Pierpaolo Sainaghi 17 , Aurora Ianniello 18 , Viviana Ravagnani 19 , Silvia Bellando Randone 20 , Paola Faggioli 21 , Claudia Lomater 22 , Paolo Stobbione 23 , Francesco Ferro 24 , Michele Colaci 25 , Giuseppina Alfieri 26 , Francesco Carubbi 27 , Gian Luca Erre 28 , Alessandro Giollo 29 , Nicoletta Franzolini 30 , Maria Chiara Ditto 31 , Silvia Balduzzi 32 , Roberto Padoan 4 , Roberto Bortolotti 7 , Alessandra Bortoluzzi 5 , Adriana Cariddi 10 , Angela Padula 11 , Gerardo Di Scala 8 , Elisa Gremese 33 , Fabrizio Conti 14 , Salvatore D'Angelo 11 , Marco Matucci Cerinic 20 , Lorenzo Dagna 10 , Giacomo Emmi 8 , Carlo Salvarani 9 , Giuseppe Paolazzi 7 , Dario Roccatello 6 , Marcello Govoni 5 , Franco Schiavon 4 , Roberto Caporali 32 , Salvatore De Vita 1 ,
Affiliation  

Introduction

Alveolar haemorrhage (AH) is considered an important cause of morbidity and early mortality in anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitides (AAV).

Objectives

The aim of this study was to identify predictors of outcome in patients with AH-AAV and to evaluate outcome and causes of death in this subset.

Materials and methods

A multicenter retrospective study was conducted in 29 Italian Centers. Clinicians were asked to recruit all patients diagnosed with AAV-associated AH during the last 10 years, from 2007 to 2016. Univariate and multivariable analysis were performed.

Results

One-hundred and six patients were included (median age at onset of 55 years [IQR 42–67]). The majority were ANCA-positive (PR3 57.1%, MPO 33.7%) and 72.6% had also renal involvement. At presentation, anaemia was shown in 97 (92.4%) patients, hemoptysis in 54 (51.9%), respiratory failure in 68 (66.7%), of whom 48 (70.6%), requiring respiratory support. At the end of the 37 months [IQR 13–77] follow-up, 19/106 (17.9%) patients were dead. The main causes of death were active disease and infections. By stepwise regression analysis, age >65 years (HR 3.66 [95% CI 1.4–9.51], p = 0.008) and the need for respiratory support (HR 4.58 [95% CI 1.51–13.87], p = 0.007) at AH onset were confirmed to be predictive of mortality.

Conclusions

Predictors of outcome in AAV-AH were determined. Factors related to the patient's performance status and the severity of the lung involvement strongly influenced the outcome. Balancing harms and benefits for the individual patient in induction and maintenance treatment strategies is crucial.



中文翻译:

ANCA相关性血管炎的肺泡出血:长期预后和死亡率预测指标。

介绍

肺泡出血(AH)被认为是抗中性粒细胞胞浆抗体(ANCA)相关血管炎(AAV)发病和早期死亡的重要原因。

目标

这项研究的目的是确定AH-AAV患者预后的指标,并评估该亚组的预后和死亡原因。

材料和方法

在29个意大利中心进行了多中心回顾性研究。从2007年到2016年,临床医生被要求招募过去10年中所有被诊断为AAV相关性AH的患者。进行了单因素和多因素分析。

结果

纳入106例患者(中位年龄为55岁[IQR 42-67])。多数为ANCA阳性(PR3为57.1%,MPO为33.7%),也有72.6%的肾脏受累。演讲时,有97名患者(92.4%)出现贫血,咯血症54名(51.9%),呼吸衰竭68名(66.7%),其中48名(70.6%)需要呼吸支持。在37个月[IQR 13-77]随访结束时,有19/106(17.9%)患者死亡。死亡的主要原因是活动性疾病和感染。通过逐步回归分析,在AH发作时年龄> 65岁(HR 3.66 [95%CI 1.4–9.51],p = 0.008)和需要呼吸支持(HR 4.58 [95%CI 1.51–13.87],p = 0.007)。被证实可以预测死亡率。

结论

确定了AAV-AH的预后指标。与患者表现状况和肺部受累严重程度有关的因素强烈影响结局。在诱导和维持治疗策略中平衡对每个患者的危害和利益至关重要。

更新日期:2020-01-09
down
wechat
bug