Khaled Safaa A A, NasrEldin Eman, Makarem Yasmine S, Mahmoud Hamdy F F
Department of Internal Medicine, Clinical Hematology Unit, Assiut University Hospital/Unit of Bone Marrow Transplantation, South Egypt Cancer Institute, Faculty of Medicine, Assiut University, Assiut, Egypt.
Department of Clinical Pathology, Assiut University Hospital, Faculty of Medicine, Assiut University, Assiut, Egypt.
J Inflamm Res. 2020 Sep 25;13:595-606. doi: 10.2147/JIR.S265811. eCollection 2020.
Disease activity score 28 (DAS28) for rheumatoid arthritis (RA) is the commonly used DAS; it relies on clinical parameters that could be subjective. This work aimed to create a more accurate DAS for RA and assess its validity.
The study included 98 RA patients and 53 matched controls; they were interviewed, clinically examined, their visual analogue scales (VAS) were reported, and then blood samples were withdrawn for erythrocyte sedimentation rate (ESR), complete blood count (CBC), and C-reactive protein (CRP). Platelet indices (PIs) were obtained from the CBC including Plt (platelet count), mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (PCT). DAS28 was calculated for each patient using RheumaHelper mobile software. Minitab Statistical Package and SPSS v20 software were used for data analysis.
Results revealed perfect matching between patients and controls as regarding age and gender. ESR, CRP and PDW were significantly higher in patients than controls; also positive correlations were detected among these variables. A new DAS for RA was developed; ESR, CRP, PDW and MPV were the components for this index. Further analyses showed that this new score was significantly higher in patients than controls and correlated with DAS28 of the patients. Furthermore the new score could identify RA patients from healthy subjects (cut off value < -0.79) and stratified RA patients according to their disease activity into low, intermediate, high, or in remission. Conclusively, we developed a more precise, easily obtained new DAS for RA. This new DAS has both diagnostic/prognostic values in patients with RA.
类风湿关节炎（RA）的疾病活动度评分28（DAS28）是常用的疾病活动度评分；它依赖于可能具有主观性的临床参数。本研究旨在创建一个更准确的RA疾病活动度评分并评估其有效性。
该研究纳入了98例RA患者和53例匹配的对照；对他们进行了访谈、临床检查，记录了他们的视觉模拟量表（VAS），然后采集血样检测红细胞沉降率（ESR）、全血细胞计数（CBC）和C反应蛋白（CRP）。从全血细胞计数中获取血小板指标（PIs），包括血小板计数（Plt）、平均血小板体积（MPV）、血小板分布宽度（PDW）和血小板压积（PCT）。使用RheumaHelper移动软件为每位患者计算DAS28。使用Minitab统计软件包和SPSS v20软件进行数据分析。
结果显示患者与对照在年龄和性别方面完全匹配。患者的ESR、CRP和PDW显著高于对照；这些变量之间也检测到正相关。开发了一种新的RA疾病活动度评分；ESR、CRP、PDW和MPV是该指标的组成部分。进一步分析表明，该新评分在患者中显著高于对照，且与患者的DAS28相关。此外，新评分可以将RA患者与健康受试者区分开来（截断值 < -0.79），并根据疾病活动度将RA患者分为低、中、高或缓解期。总之，我们开发了一种更精确、易于获得的新RA疾病活动度评分。这种新的DAS在RA患者中具有诊断/预后价值。
