甲氨蝶呤治疗类风湿性关节炎患者肝纤维化的评估:纤维扫描和生化标志物在常规临床实践中的应用

IF 1.2 Q4 RHEUMATOLOGY

Reumatologia Clinica Pub Date : 2023-10-01 DOI:10.1016/j.reuma.2022.12.003

Andrea de Diego-Sola , Agustín Castiella Eguzkiza , Luis María López Domínguez , Iratxe Urreta Barallobre , María José Sánchez Iturri , Joaquín María Belzunegui Otaño , Eva María Zapata Morcillo

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引用次数: 0

摘要

目的研究应用FibroScan和APRI指数检测甲氨蝶呤（MTX）治疗类风湿性关节炎（AR）患者肝纤维化（LF）的发生率。方法对59例RA患者进行MTX检查。根据甲氨蝶呤累积剂量比较医疗记录、FibroScan测量和肝损伤血清学标志物。结果平均治疗时间为82.4±65.1个月，平均累积剂量为5214.5±4031.9 mg。5例患者通过纤维扫描符合LF标准，而只有1例患者具有提示性APRI评分。在累积剂量高于和低于4000 mg的患者之间，通过APRI和fibroScan测量的LF没有发现统计学上的显著差异。LF和治疗时间之间也没有关系。结论MTX治疗RA患者LF的发生是一个多因素的过程，似乎与其累积剂量没有直接关系。FibroScan在临床实践中可能是一种有用的技术来筛查这种并发症。

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Assessment of liver fibrosis in patients with rheumatoid arthritis treated with methotrexate: Utility of fibroscan and biochemical markers in routine clinical practice

Objectives

To study the prevalence of liver fibrosis (LF) measured by FibroScan and APRI index in patients with rheumatoid arthritis (AR) undergoing treatment with methotrexate (MTX).

Methods

We included 59 patients with RA on MTX. Medical records, FibroScan measures and serological markers of liver damage were compared on the basis of cumulative methotrexate dose.

Results

Mean treatment duration was 82.4 ± 65.1 months and mean cumulative dose was 5214.5 ± 4031.9 mg. Five patients met LF criteria by fibroscan, while only one patient had a suggestive APRI score. No statistically significant differences were found in terms of LF measured by both APRI and fibroScan between patients with cumulative doses above and below 4000 mg. There was also no relationship between LF and treatment duration.

Conclusions

The occurrence of LF in patients with RA on MTX is a multifactorial process that does not seem directly related to its cumulative dose. FibroScan may be a useful technique in clinical practice to screen for this complication.

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来源期刊

Reumatologia Clinica RHEUMATOLOGY-

CiteScore

2.40

自引率

6.70%

发文量

105

审稿时长

54 days

期刊介绍： Una gran revista para cubrir eficazmente las necesidades de conocimientos en una patología de etiología, expresividad clínica y tratamiento tan amplios. Además es La Publicación Oficial de la Sociedad Española de Reumatología y del Colegio Mexicano de Reumatología y está incluida en los más prestigiosos índices de referencia en medicina.