Mourão Ana F, Santos Maria J, Melo-Gomes José, Martins Fernando M, Costa José A, Ramos Filipa, Brito Iva, Duarte Cátia, Figueira Ricardo, Figueiredo Guilherme, Furtado Carolina, Lopes Ana, Oliveira Margarida, Rodrigues Ana, Salgado Manuel, Sousa Miguel, Branco Jamie C, Fonseca João E, Canhão Helena
Instituto de Medicina Molecular and Hospital Egas Moniz, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal.
Arthritis Care Res (Hoboken). 2014 Apr;66(4):585-91. doi: 10.1002/acr.22215.
Our aims were to evaluate the correlation between Juvenile Arthritis Disease Activity Score 27-joint reduced count (JADAS27) with erythrocyte sedimentation rate (ESR) and JADAS27 with C-reactive protein (CRP) scores and to test the agreement of both scores on classifying each disease activity state. We also aimed at verifying the correlation of the 2 scores across juvenile idiopathic arthritis (JIA) categories and to check the correlation between JADAS27-ESR and clinical JADAS27 (JADAS27 without ESR).
A nationwide cohort of patients with JIA registered in the Portuguese Register, Reuma.pt, was studied. JADAS27-CRP was adapted by replacing ESR with CRP level as the inflammatory marker. JADAS27-CRP was calculated similarly to JADAS27-ESR as the simple linear sum of its 4 components. Pearson's correlations and K statistics were used in the analyses.
A total of 358 children had full data to calculate JADAS27; 65.4% were female and the mean ± SD disease duration was 11.8 ± 9.1 years. The correlation coefficient between JADAS27-ESR and JADAS27-CRP was 0.967 (P < 0.0001), although the correlation coefficient between ESR and CRP level was 0.335 (P < 0.0001). The strong correlation between JADAS27-ESR and JADAS27-CRP was maintained when compared within each JIA category. The agreement between JADAS27-ESR and JADAS27-CRP across the 4 activity states was very good, showing 91.1% of the observations in agreement; K = 0.867 (95% confidence interval 0.824-0.91). The correlation between JADAS27 with ESR and JADAS27 without ESR was high (r = 0.97, P < 0.0001).
JADAS27 based on CRP level correlated closely with JADAS27-ESR across all disease activity states and JIA categories, indicating that both measures can be used in clinical practice. Moreover, the correlation of JADAS27 with and without ESR was also high, suggesting that this tool might be useful even in the absence of laboratorial measures.
我们的目的是评估青少年关节炎疾病活动评分27关节减少计数（JADAS27）与红细胞沉降率（ESR）之间的相关性，以及JADAS27与C反应蛋白（CRP）评分之间的相关性，并检验这两种评分在对每种疾病活动状态进行分类时的一致性。我们还旨在验证这两种评分在青少年特发性关节炎（JIA）各分类中的相关性，并检查JADAS27-ESR与临床JADAS27（不包括ESR的JADAS27）之间的相关性。
对在葡萄牙登记处Reuma.pt登记的全国性JIA患者队列进行研究。通过用CRP水平替代ESR作为炎症标志物来调整JADAS27-CRP。JADAS27-CRP的计算方法与JADAS27-ESR类似，为其4个组成部分的简单线性总和。分析中使用了Pearson相关性和K统计量。
共有358名儿童有完整数据来计算JADAS27；65.4%为女性，平均±标准差病程为11.8±9.1年。JADAS27-ESR与JADAS27-CRP之间的相关系数为0.967（P<0.0001），尽管ESR与CRP水平之间的相关系数为0.335（P<0.0001）。在每个JIA分类中进行比较时，JADAS27-ESR与JADAS27-CRP之间保持着强相关性。JADAS27-ESR与JADAS27-CRP在4种活动状态之间的一致性非常好，91.1%的观察结果一致；K=0.867（95%置信区间0.824-0.91）。JADAS27与ESR之间以及不包括ESR的JADAS27之间的相关性很高（r=0.97，P<0.0001）。
基于CRP水平的JADAS27在所有疾病活动状态和JIA分类中与JADAS27-ESR密切相关，表明这两种测量方法均可用于临床实践。此外，包括和不包括ESR的JADAS27之间的相关性也很高，这表明即使在没有实验室检测的情况下，该工具可能也有用。
