anca相关血管炎患者静脉血栓栓塞(VTE)的发生率在不同人群中有所不同。此外,由于发生的事件较少,这些患者静脉血栓栓塞的危险因素描述较少。检索了Ovid MEDLINE、EMBASE和Cochrane图书馆的合格文章。纳入标准包括观察性研究,纳入年龄≥18岁诊断为anca相关血管炎的患者。静脉血栓栓塞的发生率是值得关注的结果。在1362篇文献中,2006 - 2019年共21篇研究(n = 4422)被纳入系统综述。平均年龄54.2±4.0岁。以男性(52.0%)和白种人(80.9%)为主。平均随访时间为5.2±2.8年,anca相关血管炎患者的VTE合并发生率为12.4% (95% CI, 8.8-17.2)。其中63.4% (95% CI, 57.3-69.1)有深静脉血栓形成,26.3% (95% CI, 17.6-37.4)有肺栓塞。 Recurrent VTE occurred in 10.0% (95% CI, 5.2-18.6). From the metaregression adjusted for age, sex, and ethnicity; positive MPO-ANCA, increasing Birmingham Vasculitis Activity Score at time of vasculitis diagnosis, and presence of renal involvement were positively associated with increased VTE events. Positive PR3-ANCA profile was inversely associated with increased VTE events. Increasing follow-up duration was not associated with increased VTE events. VTE in ANCA-associated vasculitis is common. Positive MPO-ANCA, increasing vasculitis activity, and presence of renal involvement were significant risk factors for VTE while positive PR3-ANCA was inversely associated with increased VTE. Key Points • Venous thromboembolism (VTE) is common in ANCA-associated vasculitis with a pooled incidence of 12.4% • Deep vein thrombosis accounts for two-third of total VTE cases • Positive MPO-ANCA profile, higher disease activity at ANCA-associated vasculitis diagnosis, and renal involvement are risk factors for VTE • Positive PR3-ANCA profile is protective factor for VTE.

参考文献

PubMed