Graudal N, Tarp U, Jurik A G, Galløe A M, Garred P, Milman N, Graudal H K
Rheumatism Research Unit of Aarhus University, Department of Rheumatology, Aarhus University Hospital, Denmark.
J Rheumatol. 2000 Jan;27(1):47-57.
To investigate the association of individual plots and time-integrated values of repeated measures of inflammatory variables with radiographic outcome in rheumatoid arthritis (RA).
In 112 patients with RA, examinations of joint swelling and joint tenderness of 68 joints, and measurement of hemoglobin (Hb) and erythrocyte sedimentation rate (ESR) were performed each year for up to 22 years after the first visit. For each of these 4 variables, the patients were divided arbitrarily into 5 characteristic subgroups by means of inspection of individual plots of longitudinal observations of the variables and divided into 5 other subgroups according to 20% percentiles of the cumulative mean values of the variables. The outcome of the subgroups was evaluated by varying degrees of radiographic events estimated by Larsen scoring of consecutive radiographs of 46 joints.
An increasing number of radiographic events in subgroups with increasing severity (increasing values of joint swelling, joint tenderness, and ESR, decreasing values of Hb) was seen for both the arbitrary subgroups and the percentile subgroups of joint swelling, Hb, and ESR, whereas the association of joint tenderness to radiographic progression was weak.
A highly significant association between inflammatory variables and radiographic outcome could be observed, indicating that the degree of inflammation is important for the development of destructive joint damage in RA.
研究类风湿关节炎（RA）中炎症变量重复测量的个体数据图及时间积分值与放射学结果之间的关联。
112例RA患者在首次就诊后长达22年的时间里，每年对68个关节进行关节肿胀和压痛检查，并测量血红蛋白（Hb）和红细胞沉降率（ESR）。对于这4个变量中的每一个，通过检查变量纵向观察的个体数据图，将患者任意分为5个特征亚组，并根据变量累积均值的20%百分位数分为另外5个亚组。通过对46个关节的连续X线片进行Larsen评分估计不同程度的放射学事件，评估亚组的结果。
对于关节肿胀、Hb和ESR的任意亚组和百分位数亚组，随着严重程度增加（关节肿胀、压痛和ESR值增加，Hb值降低），亚组中的放射学事件数量增加，而关节压痛与放射学进展之间的关联较弱。
可观察到炎症变量与放射学结果之间存在高度显著的关联，表明炎症程度对RA中破坏性关节损伤的发展很重要。
