采用超敏C反应蛋白评估显微镜下多血管炎预后的临床研究

A Cohort Study to Assess the Role of High-sensitivity C-reactive Protein in the Evaluation of Activity and Prognosis of Microscopic Polyangiitis

目的:探讨超敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP)显微镜下多血管炎(microscopic polyangiitis,MPA)病情及预后的影响。方法:以2008年6月23日~2017年1月20日共149例MPA患者为研究对象,收集患者人口学特征、实验室指标、病理资料等,并按照hs-CRP的中位数分组,以中位数7.05为界点,大于中位数者为高hs-CRP组,小于等于中位数者为低hs-CRP组,比较两组患者的临床特征及其预后。结果:高hs-CRP组患者基线新月体型MPA患者比例显著高于低hs-CRP组,硬化型比例低于低hs-CRP组,高hs-CRP组患者到达终点事件(全因死亡,肾替代治疗)显著高于低hs-CRP组,经多因素Cox回归分析表明hs-CRP水平及肾间质炎细胞浸润是MPA患者发生终点事件的独立危险因素。结论:血清hs-CRP水平是MPA患者预后不良的危险因素,提示血清hs-CRP可作为MPA患者评估病情及预后指标。

Objective:To investigate the role of high-sensitive C-reactive protein(hs-CRP)for the evaluation of activity and prognosis of microscopic polyangiitis.Methods:A total of 149 patients with MPA were enrolled from June 23rd to January 20,2017.We collected demographic characteristics,biochemical parameters and pathological changes.These patients were divided into high hs-CRP group and low hs-CRP group at the cutpoint of 7.05 of the median of hs-CRP of these patients to compare the clinical features and prognosis between these two groups.Results:The ratio of crescentic type in the high hs-CRP group was significantly higher than that in the low hs-CRP group.The ratio of sclerotic type was lower than that in the low hs-CRP group.The cases to reach the primary outcome(death,renal replacement therapy)in the hs-CRP group were significantly higher than that in the low hs-CRP group.The hs-CRP level and renal interstitial infiltrates were independent risk factors for the progression of microscopic polyangiitis.Conclusion:Baseline serum hs-CRP was a risk factor for the progression of microscopic polyangiitis.Serum hs-CRP could be adopted as a clinical parameter for the evaluation of microscopic polyangiitis.