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患者指数数据3(RAPID3)常规评估在中国类风湿关节炎患者疾病活动监测中的表现。

Performance of routine assessment of patient index data 3 (RAPID3) in monitoring disease activity of Chinese rheumatoid arthritis patients.

作者信息

Zhang Xiaohui, Xie Anzhi, Wang Yu, Deng Xuerong, Geng Yan, Ji Lanlan, Hao Yanjie, Li Guangtao, Zhang Zhuoli

机构信息

Department of Rheumatology and Clinical Immunology, Peking University First Hospital, Beijing, China.

出版信息

Int J Rheum Dis. 2018 Nov;21(11):1940-1945. doi: 10.1111/1756-185X.13405. Epub 2018 Nov 6.

Abstract

AIM

To explore the performance of routine assessment of patient index data 3 (RAPID3) in reflecting disease activity in Chinese rheumatoid arthritis (RA) patients.

METHOD

The clinical data of 189 consecutive RA patients, including RAPID3 questionnaire, Disease Activity Score based on 28-joint count (DAS28), clinical disease activity index (CDAI) and simplified disease activity index (SDAI), and ultrasonography of hand and wrist joints were collected. The consistency between RAPID3 and DAS28, CDAI, SDAI in RA patients with different disease activities was performed by Spearman's correlations, kappa and/or weighted kappa coefficients.

RESULT

RAPID3 score was significantly associated with DAS28 and erythrocyte sedimentation rate (ESR), DAS28 with C-reactive protein (CRP), CDAI, SDAI (r = 0.797, 0.786, 0.784, and 0.760 respectively, P < 0.001 for all). RAPID3 was also significantly correlated with tender joint count, swollen joint count, ESR and CRP. The agreement of RAPID3 with DAS28 scoring systems was better in patients with moderate/high disease activity than those in remission/low disease activity. Ultrasonographic subclinical synovitis was presented in 42.3%-48.6% of patients in remission/low disease activity defined by various scoring criteria including RAPID3 with no significant difference observed (P = 0.22, >0.05).

CONCLUSION

RAPID3 showed good correlation with DAS28 scoring systems, especially in patients with moderate/high disease activity. RAPID3 is a reliable and convenient tool to monitor disease activity.

摘要

目的

探讨患者指数数据3(RAPID3)常规评估在中国类风湿关节炎(RA)患者中反映疾病活动度的表现。

方法

收集189例连续的RA患者的临床资料,包括RAPID3问卷、基于28个关节计数的疾病活动评分(DAS28)、临床疾病活动指数(CDAI)和简化疾病活动指数(SDAI),以及手和腕关节的超声检查结果。采用Spearman相关性分析、kappa和/或加权kappa系数分析不同疾病活动度RA患者中RAPID3与DAS28、CDAI、SDAI之间的一致性。

结果

RAPID3评分与DAS28及红细胞沉降率(ESR)显著相关,DAS28与C反应蛋白(CRP)、CDAI、SDAI显著相关(r分别为0.797、0.786、0.784和0.760,均P<0.001)。RAPID3还与压痛关节数、肿胀关节数、ESR和CRP显著相关。在疾病活动度为中度/高度的患者中,RAPID3与DAS28评分系统的一致性优于缓解期/低疾病活动度的患者。在包括RAPID3在内的各种评分标准定义的缓解期/低疾病活动度患者中,42.3%-48.6%的患者存在超声亚临床滑膜炎,差异无统计学意义(P=0.22,>0.05)。

结论

RAPID3与DAS28评分系统具有良好的相关性,尤其是在疾病活动度为中度/高度的患者中。RAPID3是监测疾病活动度的可靠且便捷的工具。

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