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首页> 外文OA文献 >High proteinase 3-anti-neutrophil cytoplasmic antibody (ANCA) level measured by the capture enzyme-linked immunosorbent assay method is associated with decreased patient survival in ANCA-associated vasculitis with renal involvement
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High proteinase 3-anti-neutrophil cytoplasmic antibody (ANCA) level measured by the capture enzyme-linked immunosorbent assay method is associated with decreased patient survival in ANCA-associated vasculitis with renal involvement

机译：通过捕获酶联免疫吸附测定法测量的高蛋白酶3-抗中性粒细胞胞质抗体（aNCa）水平与患有肾脏受累的aNCa相关性血管炎患者存活率降低相关

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Wegener granulomatosis (WG) and microscopic polyangiitis (MP), diseases associated with antineutrophil cytoplasmic antibodies (ANCA), had an extremely poor prognosis before the introduction of cyclophosphamide and corticosteroids for their treatment. However, there is still reduced patient survival, and some studies have documented severe side effects of the immunosuppressants used. This 10-yr follow-up study assessed 117 consecutive patients with WG or MP with biopsy-confirmed renal involvement. The cumulative relative patient survival was lower: 0.664 for women and 0.648 for men. The causes of death (n = 64) were in most cases registered as associated with the vasculitic disease. Analysis of possible predictive factors for patient survival by multiple Cox regression analysis revealed that a very high level of proteinase 3 (PR3)-ANCA measured by the capture ELISA method, a diagnosis of MP, and older age were factors predicting poorer patient survival. High levels of B-thrombocytes at time of diagnosis were associated with a better prognosis. For patients surviving the first year, remission-sustaining therapy with azathioprine for longer than 12 mo was associated with improved patient survival. Thirty-nine patients developed end-stage renal failure. Elevated serum creatinine at time of diagnosis and a very high level of PR3-ANCA by capture ELISA were factors predicting a higher risk for renal failure during follow-up. The epitope on PR3 assessed by capture ELISA needs to be further analyzed and explored: it seemed to implicate poorer patient and renal survival in WG or MP with renal involvement.
机译：Wegener肉芽肿病（WG）和显微多血管炎（MP）是与抗中性粒细胞胞浆抗体（ANCA）相关的疾病，在引入环磷酰胺和皮质类固醇治疗之前，其预后极差。但是，患者的存活率仍然降低，并且一些研究已证明所用免疫抑制剂的严重副作用。这项为期10年的随访研究评估了117例连续活检证实为肾脏受累的WG或MP患者。累积的相对患者生存率较低：女性为0.664，男性为0.648。在大多数情况下，死亡原因（n = 64）被记录为与血管疾病有关。通过多重Cox回归分析对患者生存的可能预测因素进行分析，结果表明，通过捕获ELISA方法测得的蛋白酶3（PR3）-ANCA含量很高，诊断为MP和年龄较大，是预测患者生存较差的因素。诊断时B淋巴细胞水平高与预后较好有关。对于存活第一年的患者，使用硫唑嘌呤维持缓解时间超过12个月的疗法可改善患者的存活率。三十九名患者发展为终末期肾衰竭。诊断时血清肌酐升高，捕获ELISA检测到PR3-ANCA含量很高，这些都是预测随访期间肾衰竭风险较高的因素。通过捕获ELISA评估的PR3上的表位需要进一步分析和探索：它似乎暗示WG或MP伴肾脏受累的患者和肾脏存活较差。

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