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Abstract：
To examine clinical course of early systemic sclerosis (SSc) and identify factors for progression of acro-osteolysis by a retrospective cohort study. Dual time-point hand radiography was performed at median interval (range 3.0 ± 0.4 years) in 64 recruited patients. Progressive acro-osteolysis was defined as the worsening of severity of acro-osteolysis according to rating scale (normal, mild, moderate, and severe). Incidence of the progression was determined. Cox regression was analyzed for the predictors. A total of 193.6 per 100 person-years, 19/64 patients had progressive acro-osteolysis with incidence of 9.8 per 100-person-years (95% CI 6.3-15.4). The median time of progressive acro-osteolysis was 3.5 years. Rate of progression increased from 1st to 3rd years follow-up with the progression rate at 1-, 2- and 3-years were 0, 2.0 and 18.3%, respectively. Patients with positive anti-topoisomerase I tended to have more progressive acro-osteolysis but no significant predictors on Cox regression. 44%, 18%, and 33% of who had no, mild, and moderate acro-osteolysis previously developed progression and 10 turned to be severe acro-osteolysis. In conclusion, the incidence of progressive acro-osteolysis was uncommon in early SSc but the rate of progression was pronouncedly increasing after three years follow-up. A half of the patients progressed to severe acro-osteolysis.
摘要：
通过回顾性队列研究，检查早期系统性硬化症（SSc）的临床过程并确定肢端骨溶解进展的因素。在64名招募的患者中，以中位间隔（范围3.0±0.4年）进行了双时间点手部X线摄影。进行性骨溶解定义为根据评分量表（正常，温和,中度,和严重）。确定进展的发生率。Cox回归分析预测因子。每100人年共193.6,19/64例患者进行性肢端骨溶解，发病率为9.8/100人年（95%CI6.3-15.4）。进行性肢端骨溶解的中位时间为3.5年。从第1年到第3年随访的进展率增加，进展率在1-，2年和3年分别为0、2.0和18.3%，分别。抗拓扑异构酶I阳性的患者倾向于有更多的进行性肢端骨溶解，但对Cox回归没有明显的预测因子。44%,18%,33%的人没有，温和,中度肢端骨溶解先前发展为进展，10例转变为重度肢端骨溶解。总之,在早期SSc中,进行性肢端骨溶解的发生率并不常见,但在3年随访后,进行性骨溶解的发生率明显升高.一半的患者进展为严重的关节骨溶解。
