基于C反应蛋白计算强直性脊柱炎疾病活动度评分的研究  

A study on calculating the ankylosing spondylitis disease activity score according to the C-reactive protein level

作　　者：冀肖健 杜君[1] 朱剑[1] 黄烽[1] 张江林[1] 

机构地区：[1]解放军总医院风湿科,北京100853

出　　处：《中华内科杂志》2016年第3期206-210,共5页Chinese Journal of Internal Medicine

基　　金：十二五国家科技支撑计划项目（2014BA107805）;国家重点基础研究发展计划（973计划）（2014CB541806）

摘　　要：目的 基于C反应蛋白（CRP）计算的强直性脊柱炎（AS）疾病活动度评分（ASDAS）（ASDAS-CRP）是评价AS疾病活动度的首选公式,本研究旨在寻找CRP取值为何水平时,计算ASDAS-CRP为最佳值,为临床准确判断AS疾病活动度提供理论依据.方法 2014年5-12月就诊于解放军总医院的AS患者386例,其中CRP≥3.5 mg/L者266例,CRP＜ 3.5 mg/L者120例.通过分析不同CRP水平时ASDAS-CRP与基于ESR计算的ASDAS（ASDAS-ESR）的一致性,明确CRP的最佳取值.结果 当CRP≥3.5 mg/L时,ASDAS-CRP与ASDAS-ESR相关性好（r=0.899,P=0.000）.如果CRP＜ 3.5 mg/L时,CRP为1.5 mg/L时ASDAS-CRP与ASDAS-ESR的一致性最好（组内相关系数为0.902;kappa系数为0.70）.变异轮换法梯度矩阵显示,CRP为1.5 mg/L时与临床疾病活动度相符.结论 CRP为1.5 mg/L时可作为当CRP＜ 3.5 mg/L时计算ASDAS-CRP的CRP最佳取值.Objective To study the prediction value of C-reactive protein （CRP） level to ankylosing spondylitis disease activity score （ASDAS）,the most widely used activity score in ankylosing spondylitis （AS）.Methods A total of 386 patients with AS were enrolled and divided into 2 groups by CRP≥3.5 mg/L （n =266） and CRP 〈 3.5 mg/L（n =120）.ASDAS-CRP was evaluated in patients with CRP below the normal range （3.5 mg/L） in different subgroups.Three methods were used to test the consistency between ASDAS-CRP and ASDAS-erythrocyte sedimentation rate （ESR）.Results The ASDAS-CRP showed a good correlation with the ASDAS-ESR when CRP level was ≥ 3.5 mg/L （r =0.899,P =0.000）.In the group of CRP 〈 3.5 mg/L,ASDAS-ESR showed better consistency with ASDAS-CRP when CRP level was below 1.5 mg/L（intra-class correlation coefficient 0.902;kappa coefficient 0.70）.By the evaluation of variant gradient matrix,CRP 1.5 mg/L coincided with disease activity states.Conclusion There is good consistency between ASDAS-CRP and ASDAS-ESR.When CRP level is below the normal range,1.5 mg/L could be a cut-off value to calculate the optimal ASDAS-CRP score.

关 键 词：脊柱炎 强直性 疾病活动度 强直性脊柱炎病情活动评分 C反应蛋白质 

分 类 号：R593.23[医药卫生—内科学]