Email Alert | RSS

Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (6): 1224-1228. doi: 10.19723/j.issn.1671-167X.2022.06.028

Previous Articles     Next Articles

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)

RICH HTML

   

PDF (PC)

CLC Number: 

  • R593.25

Table 1

Comparisons of demographic characteristics between the two groups"

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

Table 2

Comparison of clinical manifestations between the two groups [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

Table 3

Comparison of laboratory indexes between the two groups"

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

Table 4

Binary logistic analysis results of factors related to RP onset of SSc"

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)
1 Wigley FM , Flavahan NA . Raynaud's phenomenon[J]. N Engl J Med, 2016, 375 (6): 556- 565.
doi: 10.1056/NEJMra1507638
2 Pauling JD , Hughes M , Pope JE . Raynaud's phenomenon: An update on diagnosis, classification and management[J]. Clin Rheumatol, 2019, 38 (12): 3317- 3330.
doi: 10.1007/s10067-019-04745-5
3 刘晶, 史群, 徐东, 等. 雷诺现象为首发表现的自身免疫性疾病疾病谱及临床特点[J]. 中华临床免疫和变态反应杂志, 2013, 7 (4): 346- 350.
4 Schneeberger D , Tyndall A , Kay J , et al. Systemic sclerosis without antinuclear antibodies or Raynaud's phenomenon: A multicentre study in the prospective EULAR scleroderma trials and research (EUSTAR) database[J]. Rheumatology (Oxford), 2013, 52 (3): 560- 567.
doi: 10.1093/rheumatology/kes315
5 Walker UA , Tyndall A , Czirják L , et al. Clinical risk assessment of organ manifestations in systemic sclerosis: A report from the EULAR scleroderma trials and research group database[J]. Ann Rheum Dis, 2007, 66 (6): 754- 763.
doi: 10.1136/ard.2006.062901
6 Matucci-Cerinic M , Kahaleh B , Wigley FM . Review: Evidence that systemic sclerosis is a vascular disease[J]. Arthritis Rheum, 2013, 65 (8): 1953- 1962.
doi: 10.1002/art.37988
7 Bairkdar M , Rossides M , Westerlind H , et al. Incidence and prevalence of systemic sclerosis globally: A comprehensive syste-matic review and meta-analysis[J]. Rheumatology (Oxford), 2021, 60 (7): 3121- 3133.
doi: 10.1093/rheumatology/keab190
8 Galetti I , Nunzio SD , Brogelli L , et al. How do systemic sclerosis manifestations influence patients' lives? Results from a survey on patients and caregivers[J]. Curr Med Res Opin, 2021, 37 (Suppl 2): 5- 15.
9 Elhai M , Meune C , Boubaya M , et al. Mapping and predicting mortality from systemic sclerosis[J]. Ann Rheum Dis, 2017, 76 (11): 1897- 1905.
doi: 10.1136/annrheumdis-2017-211448
10 Preliminary criteria for the classification of systemic sclerosis (scleroderma) . Subcommittee for scleroderma criteria of the American Rheumatism Association Diagnostic and Therapeutic Criteria Committee[J]. Arthritis Rheum, 1980, 23 (5): 581- 590.
doi: 10.1002/art.1780230510
11 van den Hoogen F , Khanna D , Fransen J , et al. 2013 classification criteria for systemic sclerosis: An American college of rheumatology/European league against rheumatism collaborative initiative[J]. Ann Rheum Dis, 2013, 72 (11): 1747- 1755.
doi: 10.1136/annrheumdis-2013-204424
12 Bussone G , Mouthon L . Interstitial lung disease in systemic sclerosis[J]. Autoimmun Rev, 2011, 10 (5): 248- 255.
doi: 10.1016/j.autrev.2010.09.012
13 Simonneau G , Robbins IM , Beghetti M , et al. Updated clinical classification of pulmonary hypertension[J]. J Am Coll Cardiol, 2009, 54 (Suppl 1): S43- S54.
14 Bruni C , De Luca G , Lazzaroni MG , et al. Screening for pulmonary arterial hypertension in systemic sclerosis: A systematic literature review[J]. Eur J Intern Med, 2020, 78, 17- 25.
doi: 10.1016/j.ejim.2020.05.042
15 Denton CP , Khanna D . Systemic sclerosis[J]. Lancet, 2017, 390 (10103): 1685- 1699.
doi: 10.1016/S0140-6736(17)30933-9
16 Maciejewska M , Sikora M , Maciejewski C , et al. Raynaud's phenomenon with focus on systemic sclerosis[J]. J Clin Med, 2022, 11 (9): 2490.
doi: 10.3390/jcm11092490
17 Rubio-Rivas M , Corbella X , Pestaóa-Fernández M , et al. First clinical symptom as a prognostic factor in systemic sclerosis: Results of a retrospective nationwide cohort study[J]. Clin Rheumatol, 2018, 37 (4): 999- 1009.
doi: 10.1007/s10067-017-3936-7
18 Launay D , Sitbon O , Hachulla E , et al. Survival in systemic sclerosis-associated pulmonary arterial hypertension in the modern management era[J]. Ann Rheum Dis, 2013, 72 (12): 1940- 1946.
doi: 10.1136/annrheumdis-2012-202489
19 Nihtyanova SI , Schreiber BE , Ong VH , et al. Prediction of pulmonary complications and long-term survival in systemic sclerosis[J]. Arthritis Rheumatol, 2014, 66 (6): 1625- 1635.
doi: 10.1002/art.38390
20 Wise RA , Wigley F , Newball HH , et al. The effect of cold exposure on diffusing capacity in patients with Raynaud's phenomenon[J]. Chest, 1982, 81 (6): 695- 698.
doi: 10.1378/chest.81.6.695
21 Wangkaew S , Pota P , Prasertwittayakij N , et al. Incidence, predictors, and survival of pulmonary hypertension determined by echocardiography in Thai patients with early systemic sclerosis (SSc): Inception cohort study[J]. Clin Rheumatol, 2021, 40 (3): 973- 980.
doi: 10.1007/s10067-020-05296-w
22 Perelas A , Silver RM , Arrossi AV , et al. Systemic sclerosis-associated interstitial lung disease[J]. Lancet Respir Med, 2020, 8 (3): 304- 320.
doi: 10.1016/S2213-2600(19)30480-1
23 Khanna D , Nagaraja V , Tseng CH , et al. Predictors of lung function decline in scleroderma-related interstitial lung disease based on high-resolution computed tomography: implications for cohort enrichment in systemic sclerosis-associated interstitial lung disease trials[J]. Arthritis Res Ther, 2015, 17, 372.
doi: 10.1186/s13075-015-0872-2
24 Rubio-Rivas M , Royo C , Simeón CP , et al. Mortality and survival in systemic sclerosis: Systematic review and meta-analysis[J]. Semin Arthritis Rheum, 2014, 44 (2): 208- 219.
doi: 10.1016/j.semarthrit.2014.05.010
25 Meunier P , Dequidt L , Barnetche T , et al. Increased risk of mortality in systemic sclerosis-associated digital ulcers: A systematic review and meta-analysis[J]. J Eur Acad Dermatol Venereol, 2019, 33 (2): 405- 409.
doi: 10.1111/jdv.15114
26 Bering J , Griffing WL , Crowell M , et al. Progression of gastrointestinal symptoms over time in patients with systemic sclerosis[J]. Rheumatol Int, 2021, 41 (7): 1281- 1287.
doi: 10.1007/s00296-021-04806-6
27 Steelandt A , Benmostefa N , Avouac J , et al. Ethnic influence on the phenotype of French patients with systemic sclerosis[J]. Joint Bone Spine, 2021, 88 (2): 105081.
doi: 10.1016/j.jbspin.2020.09.013
28 Kowal-Bielecka O , Fransen J , Avouac J , et al. Update of EULAR recommendations for the treatment of systemic sclerosis[J]. Ann Rheum Dis, 2017, 76 (8): 1327- 1339.
doi: 10.1136/annrheumdis-2016-209909
[1] Wen-gen LI,Xiao-dong GU,Rui-qiang WENG,Su-dong LIU,Chao CHEN. Expression and clinical significance of plasma exosomal miR-34-5p and miR-142-3p in systemic sclerosis [J]. Journal of Peking University (Health Sciences), 2023, 55(6): 1022-1027.
[2] Zhuo-hua LIN,Ru-yi CAI,Yang SUN,Rong MU,Li-gang CUI. Methodology and clinical use of superb microvascular imaging in assessing micro-circulation changes of fingertips in systemic sclerosis [J]. Journal of Peking University (Health Sciences), 2023, 55(4): 636-640.
[3] MA Xiang-bo,ZHANG Xue-wu,JIA Ru-lin,GAO Ying,LIU Hong-jiang,LIU Yu-fang,LI Ying-ni. Application of lymphocytes test in peripheral blood of patients with systemic sclerosis during the treatment [J]. Journal of Peking University (Health Sciences), 2021, 53(4): 721-727.
[4] Hong-lin ZHU,Qian DU,Wei-lin CHEN,Xiao-xia ZUO,Quan-zhen LI,Si-jia LIU. Altered serum cytokine expression profile in systemic sclerosis and its regulatory mechanisms [J]. Journal of Peking University(Health Sciences), 2019, 51(4): 716-722.
[5] JI Lan-lan, WANG He, ZHANG Xiao-hui, ZHANG Zhuo-li. Correlation between nailfold capillaroscopic findings and presence of interstitial lung disease in systemic sclerosis patients [J]. Journal of Peking University(Health Sciences), 2018, 50(3): 501-506.
[6] DOU Jing-li，BAI Li，PANG Chun-yan，ZHANG Wen-lan，ZHANG Wei，WANG Yong-fu. Therapeutic effect of adipose tissue-derived stem cells on bleomycin-induced mice of scleroderma [J]. Journal of Peking University(Health Sciences), 2016, 48(6): 970-976.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd