郑州类风湿：轻度嗜酸性粒细胞增高的类风湿关节炎患者对治疗的反

来源：郑州痛风风湿病医院       |    时间:2017-11-22|

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嗜酸性粒细胞增高对新发的类风湿关节炎的预示作用很小，而是直接与类风湿关节炎相关。

确定嗜酸性粒细胞增高在新发的类风湿关节炎中的流行情况，这对类风湿关节炎发生的是否有预示作用，并对他们的特征及结局进行描述。

我们对进行的一项多中心队列研究进行数据分析，这项研究是对病程6周至6个月的炎性关节炎患者进行临床、实验室和影像学数据进行监测。我们确定嗜酸性粒细胞的比例，定义在基线的基础上，3年后嗜酸性粒细胞的计数>500/mm3。基线时嗜酸性粒细胞增高和不增高的患者进行比较，描述嗜酸性粒细胞增高患者的特征。

804个患者中，有26个(3.2%)在基线时嗜酸性粒细胞增高;他们的嗜酸性粒细胞平均计数是 637.7±107/mm3。基线时嗜酸性粒细胞增高的26个患者中有6个(23.1%)患特应性皮炎综合征。3年后，嗜酸性粒细胞增高的患者有较高的HAQ评分(0.9 vs 0.5, p=0.004)、视觉模拟评分和较高的晨僵程度(p=0.05)，并且更频繁使用改善病情的抗风湿药物(p=0.02)。基线时嗜酸性粒细胞增高与关节外表现没有相关性。

嗜酸性粒细胞增高对新发的类风湿关节炎的预示作用很小，而是直接与类风湿关节炎相关。我们的数据显示，伴轻度嗜酸性粒细胞增高的类风湿关节炎患者对治疗的反应较没有嗜酸性粒细胞增高的患者差。

郑州类风湿：轻度嗜酸性粒细胞增高的类风湿关节炎患者对治疗的反应较差

OBJECTIVES:To determine the prevalence ofeosinophilia in patients with recent-onset arthritis suggestive of rheumatoidarthritis (RA) and to describe their features and outcomes.

METHODS:Weperformed an ancillary study of data from a French prospective multicentrecohort study monitoring clinical, laboratory and radiographic data in patientswith inflammatory arthritis of 6 weeks to 6 monthsduration. We determined the proportion of patients with eosinophilia, definedas a count >500/mm(3), at baseline and after 3 years.Features of patients with and without baseline eosinophilia werecompared.

RESULTS:Baseline eosinophilia was evidenced in 26 of 804 (3.2%)patients; their mean eosinophil count was 637.7±107/mm(3).Baseline eosinophilia was ascribed to atopic syndrome in 6 of 26 (23.1%)patients. After 3 years, patients with eosinophilia hadhigher Health Assessment Questionnaire scores (0.9 vs 0.5, p=0.004), higherpatient visual analogue scale activity score and morning stiffness intensity(p=0.05), and were more often taking disease-modifying antirheumatic drugs(p=0.02). Baseline eosinophilia was not associated with presence of extra-articularmanifestations.

CONCLUSIONS:Eosinophilia is rare in recent-onset arthritissuggestive of RA, and is usually directly related to the rheumatic disease. Ourdata suggest that patients with mild eosinophilia at diagnosis could respondworse to the treatment than those without.

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