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Increased ischemic stroke, acute coronary artery disease and mortality in patients with granulomatosis with polyangiitis and microscopic polyangiitis.
伴有多血管炎和显微多血管炎的肉芽肿病患者缺血性中风、急性冠状动脉疾病和死亡率增加。
ANCA-Associated vasculitis Coronary artery disease Granulomatosis with polyangiitis Ischemic stroke Microscopic polyangiitis
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摘要

OBJECTIVE:The aim of our study was to assess major cardiovascular event incidence, predictors, and mortality in ANCA-associated vasculitis (AAV).
METHODS:We conducted a retrospective cohort study of all GPA or MPA, according to Chapel Hill Consensus Conference classification criteria, diagnosed between 1981 and 2015. Major cardiovascular event was defined as acute coronary artery disease, or ischemic stroke, or peripheral vascular disease requiring a revascularization procedure. We calculated the comparative morbidity/mortality figure (CMF) and we used Cox proportional hazards regression models to assess the risk of coronary artery disease, ischemic stroke associated with AAV, after adjusting for covariates.
RESULTS:125 patients, 99 GPA (79,2%) and 26 MPA (20,8%), were followed 88.4 ± 78.3 months. Ischemic stroke incidence was four times higher than in the general population (CMF 4,65; 95% CI 4,06-5,31). Coronary artery disease incidence was four times higher than in the general population (CMF 4,22; 95% CI 1,52-11,68). Smoking habits and history of coronary artery disease were strongly associated with coronary artery disease occurrence (adjusted HR 8.8; 95% CI 2.12-36.56, and adjusted HR 10.3; 95% CI 1.02-104.5, respectively). ENT flare-up was an independent protective factor for coronary artery disease occurrence. We did not identify factors significantly associated with stroke occurrence. The age-adjusted mortality rate was 22.5 per 1000 person-years. Mortality in AAV was 1.5 times higher than in the general population (CMF 1.56; 95% CI 1.34-1.83).
CONCLUSION:AAV have a significantly increased risk of mortality, ischemic stroke, and coronary artery disease.

译文

目的: 我们研究的目的是评估 ANCA 相关血管炎 (AAV) 的主要心血管事件发生率、预测因素和死亡率。
方法: 我们根据教堂山共识会议分类标准,对 1981年至 2015 间诊断的所有 GPA 或 MPA 进行了回顾性队列研究。主要心血管事件被定义为急性冠状动脉疾病,或缺血性中风,或需要血运重建程序的外周血管疾病。我们计算了比较发病率/死亡率 (CMF),并在调整协变量后,使用 Cox 比例风险回归模型评估冠状动脉疾病、与 AAV 相关的缺血性中风的风险。
结果: 125 例患者,99 'gpa (88.4) 和 26' mpa (),随访 ± 78.3 个月。缺血性中风的发病率比普通人群高四倍 (CMF 4,65; 95% CI 4,06-5,31)。冠状动脉疾病的发病率是普通人群的四倍 (CMF 4,22; 95% CI 1,52-11,68)。吸烟习惯和冠状动脉疾病史与冠状动脉疾病的发生密切相关 (调整后的 HR 8.8; 95% CI 2.12-36.56,调整后的 HR 10.3; 95% CI 1.02-104.5, 分别)。耳鼻喉炎是冠状动脉疾病发生的独立保护因素。我们没有确定与中风发生显著相关的因素。年龄调整后的死亡率为每 22.5 人年 1000 人。AAV 的死亡率是普通人群的 1.5 倍 (CMF 1.56; 95% CI 1.34-1.83)。
结论: AAV 显著增加了死亡率、缺血性中风和冠状动脉疾病的风险。

Granulomatosis with polyangiitis

呼吸 全身血管炎综合征 疾病
概述  :  

疾病概述 肉芽肿性多血管炎又称韦格纳肉芽肿,是一种罕见的全身血管炎综合征,以呼吸道肉芽肿性炎症、中小血管坏死性血管炎和坏死性肾小球肾炎为特点。大部分韦格纳肉芽肿患者都有胞浆型抗中性粒细胞抗体。皮损最常见的病理表现为白细胞碎裂性血管炎。 诊断(1)好发于40~50岁,男性多见。(2)上呼吸道损害:最初常表现为流鼻涕、鼻塞和鼻咽部溃疡。常见鼻、咽、气管、支气管多发性结节、溃疡、出血,肺部结节损害可引起咳嗽、呼吸困难、胸痛等。发生在鼻、口腔、牙龈等处的溃疡可引起深在性溃疡穿孔。(3)皮肤损害

Granulomatosis   /'ɡrænju,ləumə'təusis/

释    义   n. 肉芽肿病

例    句   The differential diagnosis between Wegner's granulomatosis and lymphomatoid granulomatosis was discussed. 本文就韦格内肉芽肿病和淋巴瘤样肉芽肿的鉴别诊断进行了讨论。

 

Polyangiitis   /pɒl'jændʒɪaɪtɪz/

释    义   n. 多血管炎,淋巴管炎

例    句   To study the clinical and pathological characteristics of microscopicpolyangiitis (MPA) with renal medium artery involvement. 探讨并发肾脏中等动脉受累的显微镜下型多血管炎(MPA)的临床与病理特点。

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