不同疾病活动性指标在类风湿关节炎疾病活动性判断中的应用比较  

Comparison among different indicators of disease activity in patients with rheumatoid arthritis

作　　者：王雷宇 徐胜前[1] 肖会[1] 蔡静[1] 刘文[1] 吴颖[1] 徐建华[1] Wang Leiyu;Xu Shengqian;Xiao Hui;Cai Jing;Liu Wen;Wu Ying;Xu Jianhua(Department of Rheumatic,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,Chin)

机构地区：[1]安徽医科大学第一附属医院风湿免疫科,合肥230022 [2]阜阳市第六人民医院风湿免疫科

出　　处：《国际免疫学杂志》2018年第3期265-270,共6页International Journal of Immunology

基　　金：国家自然科学基金（81302587）;安徽省自然科学基金（1308085MH163）

摘　　要：目的比较基于28个关节疾病活动指数（disease activity score 28 joint，DAS 28）、临床疾病活动指数（clinical disease activity index，CADI）、简化疾病活动指数（simplified disease activiey index，SDAI）在类风湿关节炎（rheumatoid arthritis，RA）疾病活动性判断中的应用。方法收集2006年1月至2014年12月安徽医科大学第一附属医院风湿免疫科住院的423例RA患者，分别采用DAS28、CDAI和SDAI进行疾病活动性的判断，并根据疾病活动性分类标准分为缓解或低疾病活动组、中度活动组和重度活动组，分析各指标在RA病情活动性判断中的意义。结果①根据DAS28标准，缓解或低疾病活动组、中度活动组和重度活动组患者比例分别为4.14%（17/423例）、38.20%（157/423例）、57.66%（237/423例）；根据CDAI标准，三组患者的比例分别为6.86%（29/423例）、29.79%（126/423例）、63.36%（268/423例）；根据SDAI标准，三组患者比例分别为5.26%（22/423例）、32.78%（137/423例）、61.96%（259/423例）。CDAI、SDAI和DAS28具有较好的相关性（Spearman相关系数分别为0.812，0.796；均P〈0.05），且CDAI、SDAI均和DAS28具有较好的一致性（Kappa值分别为0.719，0.740，P均〈0.05）。②两两直线相关结果显示，CDAI、SDAI均和DAS28具有显著的正相关性（r分别为0.913，0.912，均P〈0.05），且CDAI和SDAI之间呈现出更高的正直线相关关系（r＝0.973，P〈0.05）。③不同疾病活动性组间RA患者的关节肿胀数、关节压痛数、健康评估问卷（healthy assessment questionnaire，HAQ）评分、血小板计数、红细胞沉降率（erthrocyte sedimentation Rate，ESR），C反映蛋白（C-reaction protein，CRP），类风湿因子（rheumatoid factor，RF）均明显不同（均P〈0.05），且随疾病活动性的增高，呈现增高趋势。血红蛋白（hemoglobin，HB）水平随疾病活动性的增高呈现降低趋势（均P〈0.05）。④两两直�ObjectiveTo compare disease activity score 28 joints DAS28, simplified disease activity index（SDAI） and clinical disease activity index（CDAI） for assessing disease activity in patients with rheumatoid arthritis （RA）. MethodTotal of 423 patients with RA hospiltalized in the department of the first Affiliated Hospital of Anhui Medical University between January 2006 and December 2014 were enrolled in this study.DAS28, CDAI and SDAI were used to evaluate disease activity.According to the classification criteria of RA, patients were divided into three groups： group of remission or low-disease activity, group of moderate-disease activity and high-disease activity.Results①According to classification criteria of DAS28, the patients in the above three groups were respectivelly accounted for 4.14%（17/423）, 38.2%（157/423） and 57.66%（237/423）. For CDAI, the ratios were 6.86%（29/423）, 29.79%（126/423） and 63.36%（268/423）. For SDAI, to ratio were 5.26%（22/423）, 32.78%（137/423） and 61.96%（259/423）. There were good correlations among CDAI, SDAI and DAS28 （Spearman correlation=0.812, 0.796; both P〈0.05）, and both CDAI and SDAI had well consistency with DAS28 （Kappa=0.719, 0.740, both P〈0.05）. ② Correlation analyses showed that CDAI and SDAI were positively correlated with DAS28（r=0.913, 0.912, both P〈0.05）, and there was a higher positive linear correlation between CDAI and SDAI（r=0.973, P〈0.05）. ③There was significant difference regarding swollen joint count, tender joint count, healthy assessment questionnaive（HAQ） score, blood platelet count, erythrocyte sedimentation Rate（ESR）, C-reaction protein（CRP）, rheumatoid factor（RF） among patients with different disease activity（P〈0.05）. All of the above indexes increased along with the rising disease activity.Serum hemoglobin（HB） levels（P〈0.05） decreased along with the rising disease activity.④DAS28, CDAI and SDAI positively correlated with swollen joint count, tender joi

关 键 词：类风湿关节炎 疾病活动性指标 基于28个关节疾病活动指数 临床疾病活动指数 简 化疾病活动指数 

分 类 号：R593.22[医药卫生—内科学]