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北京大学学报（医学版） ›› 2022, Vol. 54 ›› Issue (6): 1224-1228. doi: 10.19723/j.issn.1671-167X.2022.06.028

• 短篇论著 • 上一篇    下一篇

以雷诺现象为首发表现的系统性硬化症临床特征及其相关因素

罗靓1,2,蔡青猛1,刘香君1,贠泽霖1,李春1,张晓盈1,*()   

  1. 1 北京大学人民医院风湿免疫科，北京 100044
    2 重庆市渝北区人民医院中医科，重庆 401120
  • 收稿日期:2022-08-22 出版日期:2022-12-18 发布日期:2022-12-19
  • 通讯作者: 张晓盈 E-mail:zhangxiaoying@pkuph.edu.cn
  • 基金资助:
    中华国际医学交流基金会基金(Z-2018-40-2101);北京大学人民医院研究与发展基金(RDE 2021-18)

靓 罗1,2,青猛 蔡1,香君 刘1,泽霖 贠1,春 李1,晓盈 张1,*()   

  • Received:2022-08-22 Online:2022-12-18 Published:2022-12-19
  • Contact: 晓盈 张 E-mail:zhangxiaoying@pkuph.edu.cn
  • Supported by:
    China International Medical Foundation(Z-2018-40-2101);Peking University People's Hospital Scientific Research Development Funds(RDE 2021-18)

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关键词: 系统性硬化症, 雷诺现象, 危险因素

中图分类号: 

  • R593.25

表1

两组患者一般资料比较"

Variables RP onset group (n=196) NRP onset group (n=105) Z/t/χ2 P
Female, n (%) 169 (86.2) 88 (83.8) 0.319 0.572
Age at onset/years, $\bar x \pm s$ 42.4±15.5 46.1±14.6 -2.064 0.040
Duration/months, M (P25, P75) 78.0 (29.0, 176.5) 52.0 (21.5, 124.5) -1.792 0.073
Smoking, n (%) 29 (14.8) 23 (21.9) 2.418 0.120
SLE, n (%) 15 (7.7) 4 (3.8) 1.708 0.191
RA, n (%) 16 (8.2) 6 (5.7) 0.605 0.437
Inflammatory myopathy, n (%) 6 (3.1) 3 (2.9) 0.000 >0.999
Hypertension, n (%) 44 (22.4) 26 (24.8) 0.205 0.651
Diabetes, n (%) 8 (4.1) 10 (9.5) 3.602 0.058
Hyperlipidemia, n (%) 16 (8.2) 9 (8.6) 0.015 0.903

表2

两组患者临床表现比较[n(%)]"

Variables RP onset group (n=196) NRP onset group (n=105) χ2 P
Skin manifestations
  Skin hardening/thickening 174 (88.8) 99 (94.3) 2.461 0.117
  Loss of digital pad tissue 26 (13.3) 5 (4.8) 5.351 0.021
Bones/muscles manifestations
  Muscle pain 34 (17.3) 20 (19.0) 0.134 0.714
  Joint swelling 59 (30.1) 34 (32.4) 0.166 0.683
  Arthralgia 93 (47.4) 57 (54.3) 1.278 0.258
Vascular manifestations
vFingertip ulcers 49 (25.0) 15 (14.3) 4.688 0.030
  Digital gangrene 7 (3.6) 0 N/A 0.101
Cardiopulmonary system manifestations
  Palpitations 22 (11.2) 14 (13.3) 0.289 0.591
  ILD 92 (46.9) 32 (30.5) 7.649 0.006
  PAH 39 (19.9) 10 (9.5) 5.399 0.020
Digestive involvement
  Reflux/Heartburn 87 (44.4) 40 (38.1) 1.110 0.292
  Stomach fullness 26 (13.3) 6 (5.7) 4.103 0.043
  Intermittent abdominal pain 13 (6.6) 3 (2.9) 1.936 0.164
Renal involvement
  Proteinuria 14 (7.1) 7 (6.7) 0.024 0.877
  Microscopic hematuria 4 (2.0) 3 (2.9) 0.002 0.963
  Renal crisis 3 (1.5) 1 (1.0) 0.000 >0.999

表3

两组实验室指标比较"

Variables RP onset group (n=196) NRP onset group (n=105) Z/t/χ2 P
TC/(mmol/L), M (P25, P75) 4.35 (3.55, 5.13) 4.40 (3.70, 5.13) -1.016 0.310
TG/(mmol/L), M (P25, P75) 1.55 (1.07, 2.15) 1.44 (1.04, 2.19) -0.349 0.727
HDL-C/(mmol/L), $\bar x \pm s$ 1.13 ± 0.36 1.13 ± 0.31 -0.062 0.951
LDL-C/(mmol/L), $\bar x \pm s$ 2.54 ± 0.80 2.74 ± 0.75 -2.205 0.028
ALT/(U/L), M (P25, P75) 16.0 (11.0, 23.0) 15.0 (11.0, 21.5) -0.764 0.445
AST/(U/L), M (P25, P75) 22.0 (17.0, 26.0) 20.0 (15.0, 25.0) -1.180 0.238
Scr/(μmol/L), M (P25, P75) 61.5 (49.0, 69.8) 59.0 (53.0, 70.0) -0.038 0.970
ESR/(mm/h), M (P25, P75) 16.0 (8.0, 25.8) 15.0 (8.0, 23.0) -1.141 0.254
CRP/(mg/L), M (P25, P75) 3.1 (1.2, 7.3) 3.2 (1.5, 7.3) -0.275 0.784
ANA positive, n (%) 190 (96.9) 97 (92.4) 2.257 0.133
Anti-Scl-70 positive, n (%) 65 (33.2) 23 (21.9) 4.189 0.041
Anti-RNP positive, n (%) 30 (15.3) 16 (15.2) 0.000 0.988
Low C3, n (%) 45 (23.0) 22 (21.0) 0.159 0.690
Low C4, n (%) 41 (20.9) 23 (21.9) 0.040 0.842
IgA elevated, n (%) 54 (27.6) 22 (21.0) 1.577 0.209
IgG elevated, n (%) 38 (19.4) 26 (24.8) 1.180 0.277
IgM elevated, n (%) 38 (19.4) 16 (15.2) 0.800 0.371

表4

RP为首发表现SSc相关因素的二元Logistic回归分析结果"

VariablesUnivariate Multivariate
B Wald P OR (95%CI) B Wald P OR (95%CI)
Age at onset -0.016 4.024 0.045 0.984 (0.968-1.000)
Diabetes -0.906 3.406 0.065 0.040 (0.154-1.158)
Loss of digital pad tissue 1.118 4.915 0.027 3.059 (1.138-8.219) 1.290 6.103 0.013 3.634 (1.306-10.118)
Fingertip ulcers 0.693 4.576 0.032 2.000 (1.060-3.774)
ILD 0.702 7.534 0.006 2.018 (1.222-3.332) 0.679 6.688 0.010 1.972 (1.179-3.299)
PAH 0.859 5.172 0.023 2.360 (1.126-4.946)
Stomach fullness 0.926 3.875 0.049 2.524 (1.004-6.343)
Anti-Scl-70 positive 0.570 4.135 0.042 1.769 (1.021-3.066) 0.596 4.211 0.040 1.814 (1.027-3.205)
Low LDL-C -0.330 4.548 0.033 0.719 (0.531-0.974) -0.403 5.979 0.014 0.668 (0.484-0.923)
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ISSN 1671-167X
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