Клинические фенотипы больных саркоидозом в реальной клинической практике

Abstract

The aim of the research. To identify clinical phenotypes of sarcoidosis using cluster analysis based on clinical and demographic characteristics and the results of laboratory and instrumental analysis of patients in real clinical practice. Material and methods. We retrospectively studied the data of outpatient records of 276 sarcoidosis patients (107 males, 169 females) aged 20-68 years (41 (30; 55) years), who had been observed for more than 2 years. We analysed the gender characteristics of the patients, the forms of sarcoidosis, clinical symptoms, laboratory and functional parameters, X-ray stages, extrapulmonary lesions, and comorbid conditions. Results. A total of 5 clusters were identified using two-step cluster analysis. Cluster 1: female and male patients with acute or chronic form of pulmonary sarcoidosis (PS) and extrapulmonary manifestations; cluster 2: women with chronic asymptomatic PS; cluster 3: females with the chronic form of clinically relevant PS; cluster 4: male patients with the chronic form of asymptomatic PS; cluster 5: men with the chronic form of clinically associated PS. In contrast to cluster 4 patients with the criteria of favorable PS course, the risk of sarcoidosis progression was 7 times higher for cluster 1 patients (OR=7.01; 95% CI 2.53- 22.95; p<0.001), and 5.7-fold higher for cluster 3 patients (OR=5.73; 95% CI 2.25–17.73; p<0.001). Patients of clusters 2 and 5 had no significant differences in laboratory and instrumental parameters compared to cluster 4 patients (p>0.05). Conclusion. Identification of clinical phenotypes of sarcoidosis in patients in clinical practice based on clinical, demographic, laboratory, functional and radiological characteristics, makes it possible to optimise the therapy choice and predict the course of the disease