类风湿关节炎活动评估指标的对比研究。

Comparative study of indices of activity evaluation in rheumatoid arthritis.

机构信息

Department of Rheumatology, Institute Mohamed Kassab, Faculty of Medicine of Tunis, University Tunis El Manar, Ksar Said, Manouba, Tunis, Tunisia.

出版信息

Ann Phys Rehabil Med. 2011 Oct;54(7):421-8. doi: 10.1016/j.rehab.2011.09.002. Epub 2011 Oct 1.

DOI:10.1016/j.rehab.2011.09.002

PMID:21996547

Abstract

INTRODUCTION

Choosing between the different indices of activity evaluation in RA is often difficult considering the very heterogeneous clinical expression of the disease. The objective of our study was to evaluate the level of similarity between SDAI, CDAI, DAS28-(ESR) and DAS28-(CRP) indices in the evaluation of RA activity.

PATIENTS AND METHODS

In this transversal study, a total of 100 patients with RA responding to the ACR 87 criteria were followed up for a period of 20 months. The correlations between the four indices were studied through the Pearson's correlation coefficient (r). The similarity between these tools was evaluated through Kendall's (K) "tau" similarity coefficient.

RESULTS

The 87 female and 13 male patients (sex ratio: 6.7F/1M) were of a mean age of 52.9±11.6 years (17-77) and have been living with RA for a mean of 8.3±9 years (2 months-41 years). The DAS28-(ESR) mean score was 5.53±1.46 [1.25-8.05]. The DAS28-(CRP) mean score was 5.01±1.44 [1.68-7.81]. The CDAI mean score was 30.72±15.04 [2-62] and that of SDAI was 28.86±15.86 [2.3-71.3]. A positive, statistically significant correlation was noted between the four indices of RA activity. The level of similarity between the different indices was good (K variation between 0.758 and 0.943). DAS28-(ESR) allowed classifying the patients in the same category of disease activity than DAS28-(CRP) in a proportion of 85%. This proportion was 88% when comparing DAS28-(ESR) to CDAI and SDAI, respectively. Regarding DAS28-(CRP) and CDAI, these two indices classified the patients in the same category in a proportion of 80%, compared to 87% regarding DAS28-(CRP) and SDAI. Finally, CDAI and SDAI classified the patients in the same category in a proportion of 92% with an excellent level of similarity.

CONCLUSION

Different evaluation indices of RA activity are currently available. DAS28 is the most used. CDAI and especially SDAI have a good level of similarity with DAS28. Their advantage is to be simple and quick, and seem therefore well adapted to the follow-up of outpatients.

摘要

简介

在评估 RA 活动时，考虑到疾病的临床表现非常多样化，常常难以在不同的活动评估指数之间进行选择。我们的研究目的是评估 SDAI、CDAI、DAS28-(ESR) 和 DAS28-(CRP) 指数在评估 RA 活动中的相似程度。

患者和方法

在这项横断面研究中，共随访了 100 名符合 ACR 87 标准的 RA 患者，随访时间为 20 个月。通过 Pearson 相关系数（r）研究了四个指数之间的相关性。通过 Kendall 的（K）“tau”相似系数评估这些工具之间的相似性。

结果

87 名女性和 13 名男性患者（性别比：6.7F/1M）的平均年龄为 52.9±11.6 岁（17-77 岁），患有 RA 的平均时间为 8.3±9 年（2 个月-41 年）。DAS28-(ESR)的平均评分是 5.53±1.46 [1.25-8.05]。DAS28-(CRP)的平均评分是 5.01±1.44 [1.68-7.81]。CDAI 的平均评分为 30.72±15.04 [2-62]，SDAI 的平均评分为 28.86±15.86 [2.3-71.3]。四个 RA 活动评估指数之间存在正相关，具有统计学意义。不同指数之间的相似程度良好（K 值在 0.758 到 0.943 之间变化）。DAS28-(ESR)能够将患者分类为与 DAS28-(CRP)相同的疾病活动类别，比例为 85%。当将 DAS28-(ESR)与 CDAI 和 SDAI 进行比较时，该比例分别为 88%和 88%。关于 DAS28-(CRP)和 CDAI，这两个指数将患者分类为相同类别的比例为 80%，而 DAS28-(CRP)和 SDAI 为 87%。最后，CDAI 和 SDAI 将患者分类为相同类别的比例为 92%，具有极好的相似性。