Abstract：
OBJECTIVE: To determine the effect of subclinical synovitis on the progression of joint disease in a cohort of patients with systemic lupus erythematosus over a mean follow-up of 10 years.
METHODS: A longitudinal follow-up of 96 patients diagnosed with lupus was performed. All patients were considered clinically free of joint disease or with minimal joint impairment at baseline and were studied through ultrasound study of their dominant hand to assess the prevalence of subclinical synovitis. Now, over 10 years after we contacted them and reviewed their evolution to determine the impact of had or had not been diagnosed with subclinical synovitis in their current joint condition.
RESULTS: Thirty-one of the 91 reached patients developed clinical progression in their joint manifestations (at least one ordinal degree of worsening). Of these, 23 (74,9%) had demonstrated subclinical synovitis at baseline. In the group of patients who did not progress clinically, 46 (76,6%) did not have this finding at the start of follow-up (p < .01, OR 9,44 95%CI 3,46-25,74). The patients in whom clinical progression was demonstrated had worse combined ultrasound scores than the rest of the patients: 6,41 SD 1,45 vs. 1,15 SD 0,97 (p < .01).
CONCLUSIONS: The finding of subclinical synovitis in patients with systemic lupus erythematosus is associated with the development of joint disease progression both clinically and ultrasonographically.
METHODS: A longitudinal follow-up of 96 patients diagnosed with lupus was performed. All patients were considered clinically free of joint disease or with minimal joint impairment at baseline and were studied through ultrasound study of their dominant hand to assess the prevalence of subclinical synovitis. Now, over 10 years after we contacted them and reviewed their evolution to determine the impact of had or had not been diagnosed with subclinical synovitis in their current joint condition.
RESULTS: Thirty-one of the 91 reached patients developed clinical progression in their joint manifestations (at least one ordinal degree of worsening). Of these, 23 (74,9%) had demonstrated subclinical synovitis at baseline. In the group of patients who did not progress clinically, 46 (76,6%) did not have this finding at the start of follow-up (p < .01, OR 9,44 95%CI 3,46-25,74). The patients in whom clinical progression was demonstrated had worse combined ultrasound scores than the rest of the patients: 6,41 SD 1,45 vs. 1,15 SD 0,97 (p < .01).
CONCLUSIONS: The finding of subclinical synovitis in patients with systemic lupus erythematosus is associated with the development of joint disease progression both clinically and ultrasonographically.
摘要：
目的：在一组系统性红斑狼疮患者平均随访10年后，确定亚临床滑膜炎对关节疾病进展的影响。
方法：对诊断为狼疮的96例患者进行纵向随访。所有患者在基线时被认为在临床上没有关节疾病或具有最小的关节损伤,并且通过他们的优势手的超声研究进行研究以评估亚临床滑膜炎的患病率。现在,在我们与他们联系并回顾他们的演变以确定在他们目前的关节状况下是否被诊断为亚临床滑膜炎的影响后10年以上。
结果：91名患者中有31名患者的关节表现出现临床进展（至少有一个序数恶化）。其中,23（74,9%）在基线时表现出亚临床滑膜炎。在临床上没有进展的患者组中，46（76,6%）在随访开始时没有这一发现（p<0.01，OR9,4495CI3,46-25,74）。显示临床进展的患者的超声综合评分比其他患者差：6,41SD1,45vs.1,15标准差0,97（p<0.01）。
结论：系统性红斑狼疮患者的亚临床滑膜炎的发现与临床和超声检查的关节疾病进展有关。
方法：对诊断为狼疮的96例患者进行纵向随访。所有患者在基线时被认为在临床上没有关节疾病或具有最小的关节损伤,并且通过他们的优势手的超声研究进行研究以评估亚临床滑膜炎的患病率。现在,在我们与他们联系并回顾他们的演变以确定在他们目前的关节状况下是否被诊断为亚临床滑膜炎的影响后10年以上。
结果：91名患者中有31名患者的关节表现出现临床进展（至少有一个序数恶化）。其中,23（74,9%）在基线时表现出亚临床滑膜炎。在临床上没有进展的患者组中，46（76,6%）在随访开始时没有这一发现（p<0.01，OR9,4495CI3,46-25,74）。显示临床进展的患者的超声综合评分比其他患者差：6,41SD1,45vs.1,15标准差0,97（p<0.01）。
结论：系统性红斑狼疮患者的亚临床滑膜炎的发现与临床和超声检查的关节疾病进展有关。
