Smyrnova Ganna
Departamento de Medicina Interna, Universidade Médica Nacional M. Gorky Donetsk, Donetsk, Ucrânia.
Rev Bras Reumatol. 2014 Nov-Dec;54(6):437-40. doi: 10.1016/j.rbr.2014.06.002. Epub 2014 Sep 28.
This study aims to investigate the relationship of hemoglobin level with disease activity in patients with rheumatoid arthritis (RA).
The hemoglobin level, the 66/68 joint count, the Disease Activity Score 28 joints (DAS28), the Health Assessment Questionnaire (HAQ), the Visual Analog Scales (VAS), the Modified Sharp Score (MSS), and the disease duration in 89 patients with RA were used to analyze the possible relationship. The World Health Organization (WHO) criteria for anemia uses a hemoglobin threshold of<120g/L for women and<130g/L for men. Pregnant or breastfeeding patients, patients with a history of other inflammatory or no inflammatory arthritis, malignancies, chronic infectious and inflammatory diseases and other diseases in the stage of decompensation were excluded from the study.
Anemia was observed in 64% of the patients (1(st) group); the other group (2(nd) group) had normal levels of hemoglobin. There was a statistically significant negative correlation between hemoglobin level and swollen and tender joints' count, DAS28, HAQ score, VAS, MSS, and disease duration (p<0.001). DAS28, HAQ score, VAS, MSS, swollen and tender joints' count and disease duration were significantly (p<0.001) higher in 1(st) versus 2(nd) group.
In conclusion, we determined that low hemoglobin level was significantly related to disability and impairment, disease activity, articular damage, pain and disease duration in RA patients in our study. We believe that by keeping disease activity under control, therefore preventing articular damage, the disability in RA patients can be lessened or possibly even eliminated.
本研究旨在探讨类风湿关节炎(RA)患者血红蛋白水平与疾病活动度之间的关系。
采用89例RA患者的血红蛋白水平、66/68关节计数、28个关节疾病活动评分(DAS28)、健康评估问卷(HAQ)、视觉模拟量表(VAS)、改良夏普评分(MSS)以及病程,分析它们之间可能存在的关系。世界卫生组织(WHO)的贫血标准为女性血红蛋白阈值<120g/L,男性<130g/L。排除妊娠或哺乳期患者、有其他炎性或非炎性关节炎病史的患者、恶性肿瘤患者、慢性感染和炎性疾病患者以及处于失代偿期的其他疾病患者。
64%的患者(第1组)存在贫血;另一组(第2组)血红蛋白水平正常。血红蛋白水平与肿胀和压痛关节计数、DAS28、HAQ评分、VAS、MSS以及病程之间存在统计学显著负相关(p<0.001)。第1组的DAS28、HAQ评分、VAS、MSS、肿胀和压痛关节计数以及病程显著高于第2组(p<0.001)。
总之,我们确定在本研究中,低血红蛋白水平与RA患者的残疾和功能损害、疾病活动度、关节损伤、疼痛以及病程显著相关。我们认为,通过控制疾病活动度,从而预防关节损伤,可以减轻或甚至消除RA患者的残疾。