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举报
2013-10-16 10:49
Erosive Hand OA Linked to Lipids
手的侵蚀性骨关节炎与脂类相关 Erosive osteoarthritis (OA) of the hand is a severe form of radiographic hand OA, rather than a distinct clinical entity, and may be driven by the presence of metabolic abnormalities, researchers reported. 研究人员报告称，手的侵袭性骨关节炎是影像学上的一种严重手部骨关节炎，而临床上并不非常清楚，代谢异常可导致该疾病。 The pattern of joint involvement in erosive OA was similar to that seen in severe non-erosive disease, particularly for symmetry, with an adjusted odds ratio of 6.5 (95% CI 3-14.1) for involvement of the same joint in the opposite hand, according to Michelle Marshall, PhD, of Keele University in Staffordshire, England, and colleagues. 根据英格兰斯塔福德郡的Keele大学Michelle Marshall博士及其同事的消息，侵袭性骨关节炎中的关节变化与严重非侵袭性疾病相似，尤其是在疾病的对称发展方面，对侧手关节手疾病侵袭的校正后OR=6.5 (95% CI 3-14.1)。 But individuals with erosive hand OA had more than twice the risk of metabolic syndrome (OR 2.7, 95% CI 1-7.1) and more than four times the risk of dyslipidemia (OR 4.7, 95% CI 2.1-10.6) compared with patients who had severe non-erosive OA,the researchers reported online in Annals of the Rheumatic Diseases. 但是患有侵袭性手骨关节炎的病人出现代谢异常症状的风险比那些非侵袭性骨关节炎病人要高超过两倍 (OR 2.7, 95% CI 1-7.1)，出现血脂异常的风险要高四倍以上(OR 4.7, 95% CI 2.1-10.6)。 Erosive hand OA differs from non-erosive disease in several ways. For instance, the onset of symptoms such as swelling, stiffness, and pain tends to be abrupt, and radiographs reveal "gull-wing" or "saw-tooth" deformities and collapse of the subchondral bone. 侵袭性手骨关节炎与非侵袭性疾病间有很多不同。比如，初始症状比如肿胀、僵硬，肌腱突然疼痛，放射学检查发现“鸥翼状”或“锯齿状”急性，软骨下骨质破坏。 Following apparent widening of the joint space, remodeling occurs, resulting in the appearance of large osteophytes and an irregular subchondral plate. 关节间隙明显增宽后，出现结构改变，导致大骨赘形成，软骨下骨盘异常。 And overall, worse clinical and radiographic outcomes -- along with systemic risk factors -- have been reported for erosive OA. 而且从总体来讲，侵袭性骨关节炎病例的临床和放射学结局更差，系统性风险因素更为恶劣。 But the cause and pathogenic processes associated with erosive OA have not been fully established, and the European League Against Rheumatism has suggested that erosive disease may be a subset of generalized hand OA. 但是侵袭性骨关节炎的致病过程尚不完全明了，欧洲抗风湿病联盟认为该病或为广义手骨关节炎的一种亚型。 To determine whether erosive hand OA actually is a separate entity or part of a continuum of severity and to identify potential risk factors, Marshall and colleagues recruited patients from a clinical assessment study of hand OA and also from a study of knee OA to provide a larger, enriched sample. 为了甄别侵袭性手骨关节炎究竟是一种独立的疾病还是（广义手骨关节炎）较为严重的一种亚型，并确定其潜在的危险因子，Marshall和同事们从手骨关节炎临床评估研究以及膝盖骨关节炎研究项目中招募病人，以此获取更大量更丰富的样本。 All participants reported hand pain and stiffness for at least "a few" days within the past month. 所有受试者都报告有手部疼痛，并在过去的一个月时间里至少有几天是僵硬的。 X-rays of the hands were scored according to the Kellgren and Lawrence (KL) system, and the presence of erosive changes was evaluated according to the Verbruggen-Veys progression scale. 手部X线表现通过凯尔格伦和劳伦斯（KL）系统进行评分，侵袭性改变的表现通过Verbruggen-Veys疾病进展量表进行评分。 A total of 1,167 patients and 8,608 hand joints were included in the analysis. 研究人员供给分析了1167名病人的8608个手部关节。 On the KL grading scale, 1,754 joints were grades 2 or higher, indicating possible or definite osteophytes and narrowing of the joint space. 在KL分级量表上，1754个手部关节至少为二级，表明可能或确定的骨赘形成以及关节间隙变窄。 Moderate-to-severe KL scores of 3 or higher were found in 425 joints, indicating the presence of multiple osteophytes, joint space narrowing, sclerosis, and possible bone deformities. 425个关节出现3分及以上的中重度KL得分，表明多骨赘出现，关节间隙变窄，关节僵硬，以及可能存在的骨骼变形。 Severe scores of 4, with large osteophytes, marked joint space narrowing, severe sclerosis, and definite bone deformities were found in 112 joints. 112例关节得分四分，病情严重，出现多个大骨赘，关节间隙显著变窄，关节严重硬化，以及明确的骨骼变形。 Erosive disease was identified in 207 joints in 80 patients. 80名病人的207个关节被确认患侵袭性疾病。 The second distal interphalangeal joint was most often affected, and significant associations were found for the overall ranked order of involved joints in both erosive and non-erosive OA (r >0.95). 第二远端指间关节最常受影响，无论是侵袭性还是非侵袭性骨关节炎，该关节与受牵连关节总体排名顺序有显著相关性。 As with symmetry, the pattern of involvement across the joints of the same hand and the same finger was similar for both erosive and non-erosive disease. 对称性方面，无论是侵袭性还是非侵袭性疾病，同一只手同一手指受到疾病影响的类型是相似的。 Patients with erosive and non-erosive disease were similar in many characteristics, including age, sex, the presence of knee OA, a family history of arthritis, and body mass index. The main difference was in the presence of dyslipidemia and metabolic syndrome. 无论是侵袭性抑或非侵袭性疾病病人，他们在许多方面的都是相似的，包括年龄、性别、膝盖骨关节炎表现、关节炎家族史以及体重指数。（两者）主要的不同点为代谢异常的表现以及代谢异常症状。 Among patients with non-erosive KL 3, a total of 6.2% had abnormal levels of cholesterol, as did 8.8% of those with non-erosive KL 4. 在KL得分3分的非侵袭性疾病病人中，6.2%的病人存在血脂水平的异常，KL得分4分的该类病人中，8.8%存在血脂异常。 In contrast, 21.2% of those with erosive disease had lipid abnormalities. 与此相对的是，患有侵袭性疾病的病人中21.2%存在脂代谢异常。 And for patients with KL 3 and 4, rates of metabolic syndrome were 4.1% and 2.9%, respectively, while the rate was 11.2% for those with erosive disease. 对于KL得分3分或4分的病人，代谢异常症状的发生率分别为4.1%和2.9%，而那些患有侵袭性疾病的病人有11.2%出现了代谢异常。 The patterns of involvement in the hand joints suggest that there are "strong similarities" between erosive OA and moderate-to-severe non-erosive OA, and may represent an evolution mediated through metabolic pathways, the researchers explained. 对此研究人员解释称，手部关节受到牵连的类型提示侵袭性骨关节炎与中重度非侵袭性骨关节炎间有“强相似性”，或代表了一种通过代谢途径介导的一种演变方式。 "The exact mechanism is not yet known but osteoarthritis is believed to share similar biochemical and inflammatory pathways to metabolic disorders, and dyslipidemia may alter lipid metabolism in a number of joint tissues," they wrote. “其确切机制目前尚未可知，但是我们相信骨关节炎与代谢异常间有相似的生化及炎症反应途径，脂代谢异常或可改变许多关节组织中的脂类代谢状况。”他们写道。 A limitation of the study was the relatively small number of patients with erosive disease. 该实验的一个限制因素为：（实验招募的）侵袭性疾病病人数量相对较少。 |
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举报
2013-10-16 10:51
编译：1283字
研究人员报告称，手的侵袭性骨关节炎是影像学上的一种严重手部骨关节炎，而临床上并不非常清楚，代谢异常可导致该疾病。 根据英格兰斯塔福德郡的Keele大学Michelle Marshall博士及其同事的消息，侵袭性骨关节炎中的关节变化与严重非侵袭性疾病相似，尤其是在疾病的对称发展方面，对侧手关节手疾病侵袭的校正后OR=6.5 (95% CI 3-14.1)。 但是患有侵袭性手骨关节炎的病人出现代谢异常症状的风险比那些非侵袭性骨关节炎病人要高超过两倍 (OR 2.7, 95% CI 1-7.1)，出现血脂异常的风险要高四倍以上(OR 4.7, 95% CI 2.1-10.6)。 侵袭性手骨关节炎与非侵袭性疾病间有很多不同。比如，初始症状比如肿胀、僵硬，肌腱突然疼痛，放射学检查发现“鸥翼状”或“锯齿状”急性，软骨下骨质破坏。 关节间隙明显增宽后，出现结构改变，导致大骨赘形成，软骨下骨盘异常。 而且从总体来讲，侵袭性骨关节炎病例的临床和放射学结局更差，系统性风险因素更为恶劣。 但是侵袭性骨关节炎的致病过程尚不完全明了，欧洲抗风湿病联盟认为该病或为广义手骨关节炎的一种亚型。 为了甄别侵袭性手骨关节炎究竟是一种独立的疾病还是（广义手骨关节炎）较为严重的一种亚型，并确定其潜在的危险因子，Marshall和同事们从手骨关节炎临床评估研究以及膝盖骨关节炎研究项目中招募病人，以此获取更大量更丰富的样本。 所有受试者都报告有手部疼痛，并在过去的一个月时间里至少有几天是僵硬的。 手部X线表现通过凯尔格伦和劳伦斯（KL）系统进行评分，侵袭性改变的表现通过Verbruggen-Veys疾病进展量表进行评分。 研究人员供给分析了1167名病人的8608个手部关节。 在KL分级量表上，1754个手部关节至少为二级，表明可能或确定的骨赘形成以及关节间隙变窄。 425个关节出现3分及以上的中重度KL得分，表明多骨赘出现，关节间隙变窄，关节僵硬，以及可能存在的骨骼变形。 112例关节得分四分，病情严重，出现多个大骨赘，关节间隙显著变窄，关节严重硬化，以及明确的骨骼变形。 80名病人的207个关节被确认患侵袭性疾病。 第二远端指间关节最常受影响，无论是侵袭性还是非侵袭性骨关节炎，该关节与受牵连关节总体排名顺序有显著相关 性。 对称性方面，无论是侵袭性还是非侵袭性疾病，同一只手同一手指受到疾病影响的类型是相似的。 无论是侵袭性抑或非侵袭性疾病病人，他们在许多方面的都是相似的，包括年龄、性别、膝盖骨关节炎表现、关节炎 家族史以及体重指数。（两者）主要的不同点为代谢异常的表现以及代谢异常症状。 在KL得分3分的非侵袭性疾病病人中，6.2%的病人存在血脂水平的异常，KL得分4分的该类病人中，8.8%存在血脂异常。 与此相对的是，患有侵袭性疾病的病人中21.2%存在脂代谢异常。 对于KL得分3分或4分的病人，代谢异常症状的发生率分别为4.1%和2.9%，而那些患有侵袭性疾病的病人有11.2%出现了代谢异常。 对此研究人员解释称，手部关节受到牵连的类型提示侵袭性骨关节炎与中重度非侵袭性骨关节炎间有“强相似性”，或代表了一种通过代谢途径介导的一种演变方式。 “其确切机制目前尚未可知，但是我们相信骨关节炎与代谢异常间有相似的生化及炎症反应途径，脂代谢异常或可改变许多关节组织中的脂类代谢状况。”他们写道。 该实验的一个限制因素为：（实验招募的）侵袭性疾病病人数量相对较少。 |
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举报
2013-10-17 17:51
1. Erosive osteoarthritis(OA) of the hand is a severe form of radiographic hand OA, rather than adistinct clinical entity, and may be driven by the presence of metabolicabnormalities, researchers reported.
1) 研究人员报告称，手的侵袭性骨关节炎是影像学上的一种严重手部骨关节炎，而临床上并不非常清楚，代谢异常可导致该疾病。 2)研究人员报告称，手的侵袭性骨关节炎是影像学上的一种严重手部骨关节炎，而不是临床上不同的疾病，代谢异常可导致该疾病。 2. Following apparentwidening of the joint space, remodeling occurs, resulting in the appearance oflarge osteophytes and an irregular subchondral plate. 1) 关节间隙明显增宽后，出现结构改变，导致大骨赘形成，软骨下骨盘异常。 2) 关节间隙明显增宽后，出现关节重塑，导致大骨赘形成，软骨板不规则。 3. All participants reportedhand pain and stiffness for at least "a few" days within the pastmonth. 1) 所有受试者都报告有手部疼痛，并在过去的一个月时间里至少有几天是僵硬的。 2) 所有受试者都报告在过去的一个月里至少有几天手部疼痛和僵硬。 |
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