系统性红斑狼疮患者抗核抗体阴性的血清转化及其与疾病发作的关系。

PubMed ID
发表日期 2020年Jun月

原始出处 狼疮
Lupus
作者 Kwon  Oh Chan  Kim  Yong-Gil  Park  Jung Hwan  Park  Min-Chan 

文献标题 系统性红斑狼疮患者抗核抗体阴性的血清转化及其与疾病发作的关系。
Seroconversion to antinuclear antibody negativity and its association with disease flare in patients with systemic lupus erythematosus.

文献摘要 OBJECTIVE

评估系统性红斑狼疮患者抗核抗体阴性血清转化率及其与随后系统性红斑狼疮发作风险的关系。

METHODS

回顾性分析系统性红斑狼疮(sle)诊断时抗核抗体阳性(滴度≥1 : 40)及至少一次重复抗核抗体试验的病历。我们测定了这些患者血清转化为抗核抗体阴性的频率,并研究了血清转化为抗核抗体阴性是否与随后的系统性红斑狼疮发作风险相关。血清转化为抗核抗体阴性被定义为抗核抗体阳性转化为滴度低于1 : 40的临界值。系统性红斑狼疮发作定义为一个新的不列颠群岛狼疮评估组A或两个新的不列颠群岛狼疮评估组B域评分。为了根据抗核抗体阴性的血清转化率估计系统性红斑狼疮发作的危险比和95%置信区间,进行了Cox回归分析,并对已知的系统性红斑狼疮发作危险因素进行了调整。Kaplan-Meier分析用于比较阴性转化者和非转化者的无耀斑存活率。

RESULTS

在175例患者中,17例(9.7%)患者血清转为抗核抗体阴性,平均53.5(25.7-84.0)个月。最后一次抗核抗体检测后,随访14.3个月(8.2-21.7个月),发现53例系统性红斑狼疮发作。血清转化抗核抗体阴性患者的系统性红斑狼疮发作风险显著降低(校正危险比0.13,95%可信区间0.03-0.58,p = 0.007)。Kaplan-Meier分析显示阴性转化者的无耀斑存活率显著高于非转化者(p = 0.004)。

CONCLUSION

在53.5个月以上的患者中,9.7%的患者血清转化为抗核抗体阴性,并且与未来较低的系统性红斑狼疮发作风险相关。


OBJECTIVE

To evaluate the rate of seroconversion to antinuclear-antibody negativity in patients with systemic lupus erythematosus and its association with subsequent systemic lupus erythematosus flare risk.

METHODS

Medical records of patients with systemic lupus erythematosus with positive antinuclear antibodies (titer ≥1 : 40) at diagnosis and at least one repeat antinuclear antibody test were reviewed. We determined the frequency of seroconversion to antinuclear antibody negativity among these patients and investigated whether seroconversion to antinuclear antibody negativity was associated with subsequent systemic lupus erythematosus flare risk. The seroconversion to antinuclear antibody negativity was defined as a conversion of positive antinuclear antibodies to a titer below the cut-off of 1 : 40. Systemic lupus erythematosus flare was defined as one new British Isles Lupus Assessment Group A or two new British Isles Lupus Assessment Group B domain scores. To estimate hazard ratios and 95% confidence intervals for systemic lupus erythematosus flare according to seroconversion to antinuclear antibody negativity, Cox regression analysis with adjustment for known systemic lupus erythematosus flare risk factors was performed. Kaplan-Meier analysis was used to compare flare-free survival rates between negative converters and non-converters.

RESULTS

Among the total 175 patients, seroconversion to antinuclear antibody negativity was found in 17 (9.7%) patients in a median 53.5 (range: 25.7-84.0) months. After the last antinuclear antibody tests, 53 systemic lupus erythematosus flare cases were identified during 14.3 (range: 8.2-21.7) months of follow-up. Systemic lupus erythematosus flare risk was significantly lower in patients with negatively seroconverted antinuclear antibodies (adjusted hazard ratio 0.13, 95% confidence interval 0.03-0.58, p = 0.007). Kaplan-Meier analysis showed significantly higher flare-free survival in negative converters than in non-converters (p = 0.004).

CONCLUSION

Seroconversion to antinuclear antibody negativity occurred in 9.7% of patients over 53.5 months and was associated with a lower future systemic lupus erythematosus flare risk.


获取全文 10.1177/0961203320917748