Kaye J J, Callahan L F, Nance E P, Brooks R H, Pincus T
Department of Radiology, Vanderbilt University Medical Center, Nashville, TN 37232.
Radiology. 1987 Dec;165(3):753-8. doi: 10.1148/radiology.165.3.3685355.
Radiographs of the hands and wrists of 201 patients with rheumatoid arthritis (RA) were scored for erosion, joint space narrowing, and malalignment. The explanatory power of these findings for measures of clinical status was studied with stepwise multiple linear regression analyses. Radiographic scores explained 59.2% of variation in physical joint count deformity scores, 58.5% of variation in limited motion scores, 22.5% of variation in grip strength scores, 20.5% of variation in button test scores, and 13.5% of variation for the American Rheumatism Association (ARA) Functional Class. Malalignment scores best explained variation in physical deformity, limited motion, and button test scores; joint-space-narrowing scores best explained variation in grip strength; erosion scores best explained variation in ARA Functional Class. When age, duration of disease, erythrocyte sedimentation rate, and rheumatoid factor titer were included in the regression analyses, results were similar to those without these variables. Therefore quantitative scores of specific radiographic findings are in themselves explanatory for measures of clinical status.
对201例类风湿关节炎（RA）患者的手部和腕部X光片进行了侵蚀、关节间隙变窄和排列不齐的评分。通过逐步多元线性回归分析研究了这些结果对临床状况测量指标的解释力。X光片评分解释了关节计数身体畸形评分中59.2%的变异、活动受限评分中58.5%的变异、握力评分中22.5%的变异、纽扣试验评分中20.5%的变异以及美国风湿病协会（ARA）功能分级中13.5%的变异。排列不齐评分最能解释身体畸形、活动受限和纽扣试验评分的变异；关节间隙变窄评分最能解释握力的变异；侵蚀评分最能解释ARA功能分级的变异。当年龄、病程、红细胞沉降率和类风湿因子滴度纳入回归分析时，结果与不包含这些变量时相似。因此，特定X光片结果的定量评分本身就能解释临床状况的测量指标。
