Mäkinen Heidi, Kautiainen Hannu, Hannonen Pekka, Möttönen Timo, Korpela Markku, Leirisalo-Repo Marjatta, Luukkainen Reijo, Puolakka Kari, Karjalainen Anna, Sokka Tuulikki
Jyväskylä Central Hospital, Jyväskylä, Finland.
J Rheumatol. 2007 Oct;34(10):1987-91. Epub 2007 Jul 1.
To examine the influence of components of the Disease Activity Score 28 (DAS28) [tender joint count (TJC), swollen joint count (SJC), patient's general health (GH), and erythrocyte sedimentation rate (ESR)] on the total DAS28 score, and overlapping of the 4 individual components in rheumatoid arthritis (RA) patients with low, moderate, or high disease activity.
The effect of each component was studied in the FIN-RACo trial patients at 6 months and in a "theoretical model," where each component of the DAS28 ranged as follows: TJC and SJC from 0 to 28, GH from 0 to 100, and ESR from 1 to 100, while the other 3 components were 0 (ESR1). Overlapping of the components was studied in the FIN-RACo trial patients at 6 months with low (DAS28 < or = 3.2), moderate (DAS28 > 3.2 and < or = 5.1), and high (DAS28 > 5.1) disease activity. The higher limit for overlapping was defined as the highest SJC in the low disease activity group, and the lower limit as the lowest SJC in the high disease activity group; the percentage of patients who fall between these limits represent overlapping in SJC. Overlapping was calculated similarly concerning TJC, ESR, and GH.
ESR had the greatest effect on DAS28, followed by TJC, GH, and SJC, while in the "theoretical model" TJC had the greatest effect on the DAS28, followed by ESR, SJC, and GH. At 6 months, overlapping was present in 54%, 45%, 49%, and 31% of patients in SJC, TJC, GH, and ESR, respectively.
In real-life patients, ESR had the greatest effect of the 4 components of DAS28 on the total DAS28 score. The values of the individual components of DAS28 overlap considerably among the 3 disease activity groups.
研究疾病活动评分28（DAS28）的各组成部分[压痛关节计数（TJC）、肿胀关节计数（SJC）、患者总体健康状况（GH）和红细胞沉降率（ESR）]对DAS28总分的影响，以及这4个个体组成部分在疾病活动度低、中或高的类风湿关节炎（RA）患者中的重叠情况。
在芬兰类风湿关节炎队列（FIN-RACo）试验患者6个月时以及在一个“理论模型”中研究各组成部分的作用，其中DAS28的每个组成部分范围如下：TJC和SJC为0至28，GH为0至100，ESR为1至100，而其他3个组成部分为0（ESR1）。在FIN-RACo试验6个月时疾病活动度低（DAS28≤3.2）、中（DAS28＞3.2且≤5.1）和高（DAS28＞5.1）的患者中研究各组成部分的重叠情况。重叠的上限定义为疾病活动度低组中最高的SJC，下限定义为疾病活动度高组中最低的SJC；落在这些界限之间的患者百分比代表SJC中的重叠情况。对TJC、ESR和GH也进行类似的重叠计算。
ESR对DAS28的影响最大，其次是TJC、GH和SJC，而在“理论模型”中TJC对DAS28的影响最大，其次是ESR、SJC和GH。在6个月时，SJC、TJC、GH和ESR中分别有54%、45%、49%和31%的患者存在重叠。
在实际患者中，ESR是DAS28的4个组成部分中对DAS28总分影响最大的。DAS28各单个组成部分的值在3个疾病活动度组之间有相当大的重叠。
