中华临床免疫和变态反应杂志2017，Vol.11Issue(2)：119-125,7.DOI:10.3969/j.issn.1673-8705.2017.02.004
重置DAS28CRP临界值对类风湿关节炎患者疾病活动度评价的影响
Effect of Resetting the DAS28CRP Thresholds on the Assessment of Disease Activityin Patients with Rheumatoid Arthritis
摘要
Abstract
Objective To testify the correlation of DAS28-CRP, DAS28-ESR, SDAI, CDAI, HAQ and SF-36 as well as the unique components of DAS28-CRP and DAS28-ESR.Furthermore, to explore the consistency between the DAS28-CRP with thresholds validated for DAS28-ESR and the new proposed and DAS28-ESR, SDAI.Methods 131 rheumatoid arthritis (RA) patients were included and the DAS28-CRP, DAS28-ESR, SDAI, CDAI, HAQ and SF-36 were calculated.Statistical analysis was carried out by Pearson's correlation, Bland altam plot and kappa coefficient.Results Four method for disease activity assessment were strongly correlated with each other, which was negatively correlated with HAQ (r<0.00, P<0.001)and positively correlated with SF-36(r>0.00, P<0.001).The unique components of DAS28-CRP and DAS28-ESR(r=0.618,P<0.001)had a relatively lower correlation than themselves(r=0.948,P<0.001).In Bland altam plot analysis, although 97.7% of point data fell between the upper and lower bounds of the limits of agreement, the percentage error (33%) was higher than the acceptable proportion of 30%.The kappa of agreement between DAS28-CRP with newly proposed thresholds and DAS28-ESR(Kappa=0.602),SDAI(Kappa=0.448)was higher than DAS28-CRP with validated thresholds for DAS28-ESR (Kappa=0.543)and between them(Kappa=0.346).The proportion of agreement also increased from 68.7% to 86.26%, and from 54.96% to 81.70% respectively.Conclusion We can use different method to make a real-time assessment of the disease activity level of a patient.Using the DAS28-CRP with threshold values validated for DAS28-ESR may lead to errors in determining of disease activity and therefore may lead to errors in the management of patients with rheumatoid arthritis.关键词
关节炎,类风湿/疾病活动度/红细胞沉降率/C反应蛋白Key words
arthritis/rheumatoid/disease activity/blood sedimentation/C-reactive protein分类
医药卫生引用本文复制引用
梁娜娜,张莉芸,张改连,许珂,王小静..重置DAS28CRP临界值对类风湿关节炎患者疾病活动度评价的影响[J].中华临床免疫和变态反应杂志,2017,11(2):119-125,7.基金项目
山西省回国留学人员科研资助项目(2012089) （2012089）
