Arthritis Rheumatol:银屑病的结构性肌腱附着点病变与出现银屑病关节炎的风险升高相关

2020-02-29 xiangting MedSci原创

在银屑病患者中,存在结构性附着点病变和附着点皮质vBMD低与出现PsA的风险升高相关。

这项研究旨在探讨银屑病患者存在结构性肌腱附着点病变是否会影响进展为银屑病关节炎(PsA)的风险。

对没有肌肉骨骼受累临床证据的银屑病患者进行了一项前瞻性队列研究。通过高分辨率外周定量CTHR-pQCT)对附着点和关节内部位的结构性附着点病变和容积骨密度(vBMD)进行基线评估。使用多因素Cox回归模型计算基线容积骨密度和存在结构性附着点病变与进展为PSA的校正相对风险。

该队列包括114名银屑病患者(M/F 72/42),平均(SD)随访时间为28.217.7)个月,期间24名患者发生PsA9.7/100患者-年,95CI 6.2-14.5)。与没有此类病变的患者相比,有结构性附着点病变的患者发生PsA的风险更高(21.4/100患者-年,95CI 12.5-34.3HR 5.1095CI 1.53-16.99p=0.008)。就vBMD而言,附着点vBMD升高1个标准差,进展为PsA的风险约降低30%,而不是关节内vBMD。特别的是,附着点的皮质vBMD较高与发生PsA的风险较低相关(每个SD HR 0.3295CI 0.14-0.71),并且在缺失数据的多次插补后仍保持稳定(HR 0.6495CI 0.42-0.98)。

在银屑病患者中,存在结构性附着点病变和附着点皮质vBMD低与出现PsA的风险升高相关。

原始出处:

David Simon. Structural entheseal lesions in patients with psoriasis are associated with an increased risk of progression to psoriatic arthritis. Arthritis Rheumatol. February 2020.

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    2020-03-02 lmm397
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    2020-03-02 zhaojie88
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