摘要
目的 探讨髓过氧化物酶抗中性粒细胞胞质抗体(MPO-ANCA)相关血管炎(AAV)患者的预后(患者生存和肾脏生存)及其相关影响因素。方法 纳入2020年1月至2020年12月于郑州大学第一附属医院确诊为MPO-ANCA相关血管炎(AAV)的58例患者。随访至2022年5月1日或结局事件[患者死亡或进入维持性血液透析(MHD)]发生,收集患者的临床资料,经单因素分析及多因素分析患者生存预后及肾脏预后的相关因素。结果 至随访结束,58例患者中44例(75.9%)存活。多因素Cox回归分析结果显示:年龄≥70岁、伯明翰血管炎活动度评分(BVAS)评分≥20分、血清肌酐(Scr)水平≥353.6μmol·L~(-1)、血液净化治疗为患者生存预后的独立影响因素(P<0.05)。最终进入MHD的患者有25例(43.1%),多因素logistic回归分析结果显示:肾脏穿刺活检、Scr水平≥353.6μmol·L~(-1)、尿红细胞计数≥20μL~(-1)为患者肾脏预后的独立影响因素。结论 年龄、BVAS评分、Scr水平、血液净化治疗是影响MPO-AAV患者生存预后的因素;Scr水平、尿红细胞计数、肾脏穿刺活检是影响患者进入MHD的因素。
Objective To explore the prognosis(patients survival,renal survival)and its influencing factors of myeloperoxidase-anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis patients.Methods A total of 58 consecutive patients with MPO-ANCA-associated vasculitis(AAV)diagnosed in the First Affiliated Hospital of Zhengzhou University from January 2020 to December 2020 were recruited.Follow up till 1st May,2022 or till the happen of outcome event[dead or in maintenance hemodialysis(MHD)].The clinical data of the patients were collected,and the prognosis for patients survival and renal survival were retrospectively analyzed by univariate analysis and multivariate analysis.Results Till the end of the follow up,there were 44(75.9%)patients alive.The results of multivariate Cox regression analysis showed that age≥70 years old,Birmingham vasculitis activity scale(BVAS)score≥20 points,and serum creatinine(Scr)level≥353.6μmol·L-1 and blood purification therapy were independent influencing factors for patient survival and prognosis(P<0.05).There were 25 patients(43.1%)eventually entered MHD,and multivariate logistic regression analysis showed that kidney biopsy and Scr level≥353.6μmol·L-1,urine red blood cell count≥20μL-1 were the independent influencing factors for renal prognosis in patients.Conclusion Age,BVAS score,Scr level,and blood purification therapy are factors that affect the survival and prognosis of MPO-AAV patients.Scr levels,urinary red blood cell count,and renal biopsy are factors that affect patients entering MHD.
作者
李昱保
刘亚敏
鲁小晴
乔颖进
王沛
LI Yubao;LIU Yamin;LU Xiaoqing;QIAO Yingjin;WANG Pei(Department of Blood Purification Center,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《河南医学研究》
CAS
2023年第22期4051-4056,共6页
Henan Medical Research
关键词
血管炎
髓过氧化物酶抗中性粒细胞胞质抗体
生存预后
肾脏预后
vasculitis
myeloperoxidase-anti-neutrophil cytoplasmic antibody
prognosis of patients survival
prognosis of renal survival
