Natural history of Beh?et’s disease focusing on remission of oral ulcers
Natural history of Beh?et’s disease focusing on remission of oral ulcers
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白塞氏病的自然史重点关注口腔溃疡的缓解
DOI：
10.1093/mr/roac035
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发表时间：
2022
影响因子：
2.2
通讯作者：
Kono Hajime
中科院分区：
文献类型：
--
作者：
Tomizuka Takafumi;Kikuchi Hirotoshi;Okubo Mai;Asako Kurumi;Miyata Satoshi;Kono Hajime
ObjectivesTo描述白塞病（BD）的各种表现的长期临床过程，并阐明参与口腔溃疡（OUR）缓解使用BD patients. Methods的临床信息的因素，我们回顾性研究了155 BD患者访问我院（1989年至2020年）。我们定义了每种表现的缓解标准，并检查了长期的临床变化。进行分类和回归树以及多变量分析，以研究预后因素;使用风险比对认为有意义的预后因素进行评分[预后评分（OuP评分）]。风险分层检查分为四个stages.ResultsOUs评分出现最早，最慢的下降后BD诊断观察到的患病率。肿瘤的存在是影响完全缓解的最常见因素。年龄小、从不吸烟、生殖器溃疡、病理学检查阳性、未使用肿瘤坏死因子抑制剂或免疫抑制剂、长期不治疗或对症治疗是不良预后因素。多因素分析显示，OuP评分预测BD完全缓解的曲线下面积为0.678。更快的复发缓解与早期的复发治疗干预有关，而不是对症治疗。
ObjectivesTo describe the long-term clinical course of each manifestation of Behçet’s disease (BD) and clarify factors involved in oral ulcer (OU) remission using clinical information of BD patients.MethodsWe retrospectively studied 155 BD patients visiting our hospital (1989–2020). We defined remission criteria for each manifestation and examined long-term clinical changes. Classification and regression trees and multivariable analyses were performed to investigate OU prognostic factors; hazard ratios were used to assign scores to prognostic factors deemed significant [OU prognosis score (OuP score)]. Risk stratification was examined by dividing the OuP scores into four stages.ResultsOUs appeared earliest, with the slowest decline in prevalence observed post-BD diagnosis. OU presence was the most common factor inhibiting complete remission. Young age at OU onset, never smoker, presence of genital ulcers, positive pathergy test, no usage of tumour necrosis factor inhibitors or of immunosuppressants, and long-term non-treatment or symptomatic treatment for OUs were poor OU prognostic factors. Based on multivariable analysis, the area under the curve of the OuP score to predict OU prognosis was 0.678.ConclusionsRemission criteria for each symptom clarified that OU had the greatest impact on complete BD remission. Faster OU remission was associated with earlier OU therapeutic intervention other than symptomatic treatment.