Salesi Mansour, Ghazvini Rozita Aghaye, Farajzadegan Ziba, Karimifar Mansoor, Karimzadeh Hadi, Masoumi Maryam, Ebrahimi Bahareh
Department of Rheumatology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Community and Preventive Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Pharm Pract. 2012 Oct;1(2):72-6. doi: 10.4103/2279-042X.108374.
Recently, adenosine deaminase (ADA) is introduced as helpful marker in diagnosis, prognosis, and monitoring of treatment in rheumatoid arthritis (RA). The aim of this study was to determine the efficacy of the serum ADA in diagnosis, prognosis, and monitoring of treatment with methotrexate (MTX) in RA.
This was a self-controlled clinical trial conducted in university hospitals of Isfahan, Iran. The serum level of ADA, erythrocyte sedimentation rate (ESR), and rheumatoid factor (RF) were measured for 70 patients with active RA (Disease Activity Score-28 [DAS28] > 3/2). After three months of MTX treatment and disease remission (DAS28 < 2.6) these markers were measured again. ANCOVA multiregression and paired t-test were used to compare and evaluate the mean level and correlation of ADA, ESR, IgM-RF, and DAS before and after RA remission.
The mean value for ADA activity was significantly higher than the normal one compared with other studies. Significant decreases were seen in values of ADA, ESR, RF, visual analogue scale (VAS), and DAS after remission. Also, the correlation coefficient between the values of ADA with ESR and DAS were statistically significant in baseline. Moreover, the statistically significant correlation between ADA and ESR, VAS, and DAS were seen after remission. No correlation was found in the case of the dosage of MTX with the value of ADA.
It was concluded that ADA may be considered useful as a marker in diagnosis, prognosis, and monitoring of treatment with Methotrexate in RA.
最近,腺苷脱氨酶(ADA)被引入作为类风湿关节炎(RA)诊断、预后及治疗监测的有用标志物。本研究旨在确定血清ADA在RA诊断、预后及甲氨蝶呤(MTX)治疗监测中的有效性。
这是一项在伊朗伊斯法罕大学医院进行的自身对照临床试验。对70例活动期RA患者(疾病活动评分-28 [DAS28] > 3/2)测定血清ADA水平、红细胞沉降率(ESR)和类风湿因子(RF)。MTX治疗三个月且疾病缓解(DAS28 < 2.6)后再次测定这些标志物。采用协方差分析多元回归和配对t检验比较和评估RA缓解前后ADA、ESR、IgM-RF及DAS的平均水平和相关性。
与其他研究相比,ADA活性的平均值显著高于正常水平。缓解后ADA、ESR、RF、视觉模拟评分(VAS)和DAS值均显著下降。此外,基线时ADA值与ESR和DAS之间的相关系数具有统计学意义。而且,缓解后ADA与ESR、VAS和DAS之间存在统计学显著相关性。未发现MTX剂量与ADA值之间存在相关性。
得出结论,ADA可被认为是RA诊断、预后及甲氨蝶呤治疗监测的有用标志物。