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血清铁蛋白、红细胞沉降率和 C 反应蛋白水平在基孔肯雅热致慢性多发性关节炎患者中的变化。

Ferritin, Erythrocyte Sedimentation Rate, and C-Reactive Protein Level in Patients with Chikungunya-Induced Chronic Polyarthritis.

机构信息

1Programa de Pós-Graduação em Ciências da Saúde, Faculdade de Medicina, Universidade Federal de Mato Grosso (UFMT), Cuiabá, Brazil.

2Clínica Médica e Reumatologia, Universidade de Cuiabá (UNIC), Cuiabá, Brazil.

出版信息

Am J Trop Med Hyg. 2020 Nov;103(5):2077-2082. doi: 10.4269/ajtmh.20-0066.

Abstract

Chikungunya virus (CHIKV) is a global emergent arthritogenic alphavirus transmitted by anthropophilic mosquitoes. Chikungunya fever may evolve to chronic arthralgia in 57-80% of infected patients. This study was developed to identify possibly fast, simple low-cost biomarkers to monitor chronic CHIKV-induced articular disease. Between 2017 and 2018, we analyzed clinical data of patients meeting the criteria established by standard protocols to define chronic chikungunya articular disease. Patients were classified according to the disease activity scores, inflammatory biomarkers (erythrocyte sedimentation rate [ESR], ferritin, and C-reactive protein [CRP] serum), positive rheumatoid factor, comorbidities, smoking, and previous use of corticosteroids determined before beginning therapy. Of 106 patients, 98 (92.5%) were women with mean age of 52 ± 13 years, 6.8 ± 4.4 months of illness duration at the first medical appointment, and 6.7 ± 4.5 affected joints. Mean ESR (26 ± 19), CRP (2.6 ± 3.6), and stratified ferritin (144 ± 115) levels were normal according to reference values. There was no significance in comparing the levels of inflammatory biomarkers and the additional variables analyzed in the presence of moderate chronic joint disease in the study population. However, we identified a negative correlation between disease activity measures and duration of disease at the first medical evaluation after initial infection ( < 0.001), corroborating data observed in the literature.

摘要

基孔肯雅热病毒(CHIKV)是一种全球性的节肢动物传播的致关节炎阿尔法病毒。57%-80%的感染患者可能会发展为慢性关节痛。本研究旨在确定可能快速、简单、低成本的生物标志物,以监测慢性基孔肯雅热病毒引起的关节疾病。在 2017 年至 2018 年期间,我们分析了符合标准方案中确定的慢性基孔肯雅热关节疾病标准的患者的临床数据。根据疾病活动评分、炎症生物标志物(红细胞沉降率 [ESR]、铁蛋白和 C 反应蛋白 [CRP] 血清)、阳性类风湿因子、合并症、吸烟和开始治疗前使用的皮质类固醇等因素,对患者进行分类。在 106 例患者中,98 例(92.5%)为女性,平均年龄为 52±13 岁,首次就诊时疾病持续时间为 6.8±4.4 个月,受累关节为 6.7±4.5 个。根据参考值,平均 ESR(26±19)、CRP(2.6±3.6)和分层铁蛋白(144±115)水平正常。在研究人群中存在中度慢性关节疾病的情况下,比较炎症生物标志物水平和分析的其他变量没有显著性差异。然而,我们发现疾病活动指标与初次感染后首次评估时疾病持续时间之间存在负相关(<0.001),这与文献中观察到的数据一致。

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