[继发性aa -淀粉样变强直性脊柱炎的发病频率、临床和实验室特征]。

IF 0.3 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Terapevticheskii Arkhiv Pub Date : 2025-06-08 DOI:10.26442/00403660.2025.05.203229

K V Sakharova, S O Krasnenko, A E Dimitreva, S F Erdes

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引用次数: 0

摘要

背景：强直性脊柱炎（AS）的发病机制以长期慢性炎症为基础，可导致继发性淀粉样变的发展。目的：分析继发性淀粉样变性在某医院AS患者队列中的发生频率，并描述其临床和实验室特征。材料与方法：对458例AS患者进行了检查。根据俄罗斯专家建议评估患者的疾病活动度和功能状态。此外，所有患者均采用浊度法测定血清SAA。在没有禁忌症的情况下，几年来实验室活动高的患者接受纤维胃十二指肠镜检查和十二指肠粘膜下层活检。结果：458例AS患者中，21例（4.5%）确诊为AA型淀粉样变；男性为5.6%，女性为2.6%。15例（3.3%）患者首次诊断为AA型淀粉样变性，仅有6例（1.3%）患者以前诊断过。ASDAS-CRP测量的aa -淀粉样变患者的疾病活动性较高，ESR值较高。与对照组相比，淀粉样变患者有更高的并发频率，并且他们接受关节置换术的频率更高。在淀粉样变患者中，患者入组年龄与是否存在关节炎、BASDAI和ASDAS指数值呈显著负相关。在对照组中未观察到以下关联。我们没有发现SAA和活动评分之间的预期关联，这些值在组间没有差异。结论：在某风湿病专科，AS患者aa -淀粉样变发生率达4.5%。淀粉样变更常发生在男性、青少年发病患者、疾病晚期、疾病活动度高的患者中。没有针对AS患者继发性淀粉样变性的针对性搜索，其在实际临床中的检出率约为30%。

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[Frequency and clinical and laboratory features of ankylosing spondylitis with secondary AA-amyloidosis].

Background: Pathogenesis of ankylosing spondylitis (AS) is based on long-term chronic inflammation, which can lead to the development of secondary amyloidosis.

Aim: To analyze the frequency of secondary amyloidosis in a hospital cohort of patients with AS and describe their clinical and laboratory features.

Materials and methods: Four hundred and fifty eight patients with AS were examined. Patients' disease activity and functional status were assessed according to the Russian expert recommendations. Additionally, in all patients, SAA in blood serum was determined using nephelometric method. Patients having high laboratory activity during several years underwent fibrogastroduodenoscopy and biopsy of the duodenum submucosal layer, in the absence of contraindications.

Results: Among 458 patients with AS, the diagnosis of AA amyloidosis was confirmed in 21 (4.5%) cases; the frequency among men was 5.6%, among women - 2.6%. In 15 (3.3%) cases, AA amyloidosis was diagnosed for the first time, and only in 6 (1.3%) patients it was diagnosed before. Patients with AA-amyloidosis had higher disease activity measured by ASDAS-CRP and higher ESR values. Patients with amyloidosis had higher frequency of syndesmophytes and they underwent joint arthroplasty more often compared to the control group. Among the patients with amyloidosis, a significant negative association was revealed between the patients' age of enrollment in the study and the presence of arthritis, the values of BASDAI and ASDAS indices. The following associations were not observed in the control group. We did not find the expected association between SAA and activity scores, these values did not differ between groups.

Conclusion: In a specialized rheumatology department, the frequency of AA-amyloidosis in patients with AS reaches 4.5%. Amyloidosis significantly more often develops in males, in patients with juvenile onset, in the late stage of the disease, in patients with high disease activity. Without a targeted search for secondary amyloidosis in patients with AS, its detection rate in real clinical practice is about 30%.

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来源期刊

Terapevticheskii Arkhiv 医学-医学：内科

CiteScore

1.40

自引率

33.30%

发文量

171

审稿时长

3-8 weeks

期刊介绍： Терапевтический архив The journal was founded by the prominent Russian therapists M.P. Konchalovsky and G.F. Lang in 1923. Then its editors-in-chief were Professors V.N. Vinogradov and A.G. Gukasyan. Since 1972, E.I. Chazov, Academician of the Russian Academy of Sciences, has been heading the editorial board of the journal. Over 90 years, there have been more than 1000 issues where the authors and editorial staff have done their best for readers to keep abreast of current advances in medical science and practice and for physicians to master the advanced principles of recognition and treatment of a wide spectrum of visceral diseases. The papers published in the journal (editorials, original articles, lectures, reviews, etc.) cover both current scientific achievements and practical experience in diagnosing, treating, and preventing visceral diseases. The authors of publications are not only Russian, but also foreign scientists and physicians. All papers are peer-reviewed by highly qualified Russian specialists. The journal is published monthly. Traditionally, each issue has predominantly certain thematic areas covering individual therapy specializations. Every year, one of the issues is devoted to related problems in practical medicine (allergology and immunology, neurology and psychiatry, obstetrics, oncology, etc.). This all draws the attention of the reading public to the journal. The journal is indexed in RSCI (Russian Science Citation Index), PubMed/Medline, Index Medicus, Scopus/EMBASE, Web of Science Core Collection (Science Citation Index Expanded), Web of Science (Russian Science Citation Index - RSCI, Current Contents Connect, BIOSIS Previews), Google Scholar, Ulrich''s Periodicals Directory. The journal is included in the list of periodicals recommended by the Higher Attestation Committee for publishing the papers containing the basic materials of doctoral and candidate dissertations. By the decision of the Presidium of the Russian Academy of Medical Sciences, the “Therapevticheskiy Arkhiv” was awarded the Botkin medal. It was admitted to the European Association of Sciences Editors (EASE). The journal was honored with the Golden Press Fund decoration at the 13th International Press Professional Exhibition.