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血清阳性和血清阴性类风湿关节炎的放射学评估。

Radiographic estimation in seropositive and seronegative rheumatoid arthritis.

机构信息

Physical Medicine Department, Clinic for Orthopaedics, University of Prishtina, Kosovo.

出版信息

Bosn J Basic Med Sci. 2011 Aug;11(3):180-4. doi: 10.17305/bjbms.2011.2571.

Abstract

Long since it have been suggested that a subpopulation of patients with rheumatoid arthritis, diagnosed with negative rheumatoid factor tests, represents a clinical entity quite distinct from that of seropositive rheumatoid arthritis (RA). Our aim was to establish a scientific comparative analysis between seronegative and seropositive rheumatoid arthritis, regarding some radiological and clinical parameters, applied for the first time on patients from Kosovo. Two hundred fifty patients with rheumatoid arthritis according to the American College of Rheumatology criteria were retrospectively studied by analysis the radiographic damage and clinical parameters of the disease, using a data base. All examinees were between 25-60 years of age (Xb=49.96, SD=10.37) with disease duration between 1-27 years (Xb = 6.41, SD=6.47). All patients underwent a standardised evaluation radiographs. Baseline standardised poster anterior radiographs of hands and feet and radiographs of other joints, depending on indications, were assessed. Erythrocyte sedimentation rate values correlated with the radiological damages and statistical difference was found for seronegative subset (r=0.24, p<0.01). Longer duration of the disease resulted in the increase of radiological changes in both subsets (r=0.66, p<0.01) seronegative, (r=0.49, p<0.01) seropositive. Anatomic changes of IInd and IIIrd level were nearly equally distributed in both subsets, 76 (60.8%) seronegative, 75 (60%) seropositive. Radiological damages are nearly equal in both subsets, elevate in relation to the duration of the disease and correlate with ESR values. Regarding the sero-status, differences within sex, with some exceptions, are not relevant. Although there are some definite quantitative and qualitative differences regarding sero-status, obviously there is a great deal of overlap between the two groups.

摘要

很久以前就有人提出,类风湿关节炎患者中有一部分人类风湿因子检测呈阴性,他们的临床特征与血清阳性类风湿关节炎(RA)患者明显不同。我们的目的是首次在科索沃患者中建立一个关于血清阴性和血清阳性类风湿关节炎的科学比较分析,研究一些放射学和临床参数。

我们回顾性地分析了 250 名符合美国风湿病学会标准的类风湿关节炎患者的放射学损伤和疾病的临床参数,使用了一个数据库。所有患者年龄在 25-60 岁之间(Xb=49.96,SD=10.37),病程在 1-27 年之间(Xb=6.41,SD=6.47)。所有患者均接受了标准评估的放射学检查。根据适应证,对基线标准的手和脚前后位放射照片和其他关节的放射照片进行了评估。红细胞沉降率值与放射学损伤相关,在血清阴性亚组中发现了统计学差异(r=0.24,p<0.01)。疾病持续时间较长导致两个亚组的放射学变化增加(r=0.66,p<0.01),血清阴性组(r=0.49,p<0.01)和血清阳性组。第二级和第三级解剖学改变在两个亚组中几乎均匀分布,76 例(60.8%)血清阴性,75 例(60%)血清阳性。两个亚组的放射学损伤几乎相等,与疾病持续时间相关,并与 ESR 值相关。关于血清状态,除了一些例外,性别内的差异并不重要。尽管在血清状态方面存在一些明确的定量和定性差异,但两组之间显然有很多重叠。

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本文引用的文献

1
Extra-articular manifestations of seronegative and seropositive rheumatoid arthritis.
Bosn J Basic Med Sci. 2010 Feb;10(1):26-31. doi: 10.17305/bjbms.2010.2729.
2
Genetic influences modulating the radiological severity of rheumatoid arthritis.
Ann Rheum Dis. 2010 Mar;69(3):476-82. doi: 10.1136/ard.2009.117721. Epub 2010 Feb 2.
3
[Bone marrow edema: definition, diagnostic value and prognostic value].
J Radiol. 2009 Dec;90(12):1789-811. doi: 10.1016/s0221-0363(09)73586-3.
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