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类风湿关节炎预后的预测因素:一项随访研究的结果

Factors predicting outcome of rheumatoid arthritis: results of a followup study.

作者信息

van Zeben D, Hazes J M, Zwinderman A H, Vandenbroucke J P, Breedveld F C

机构信息

Department of Rheumatology, University Hospital, Leiden, The Netherlands.

出版信息

J Rheumatol. 1993 Aug;20(8):1288-96.

PMID:8230007
Abstract

OBJECTIVE

To determine prognostic factors in rheumatoid arthritis (RA).

METHODS

One hundred thirty-two women with definite RA were followed yearly from an early phase of the disease (symptoms < 5 years) for a mean duration of 6 years. The prognostic value of the first available clinical and laboratory variables and assessments of functional ability was related to several outcome measures (physician's opinion of disease severity, disease activity, radiological abnormalities, functional ability and number of prescribed 2nd-line drugs) by single predictor analysis and by logistic regression.

RESULTS

The variables most predictive for one or more of the outcome measures were number of swollen joints, Ritchie score, health assessment questionnaire score, radiographical abnormalities, positive IgM rheumatoid factor (RF), positive IgG-RF, HLA-DR4, and an elevated percentage serum agalactosyl IgG. The accuracy of predicting outcome was calculated from several combinations of these variables, and varied between 70 and 80%. The accuracy based on a combination of the commonly available variables (number of swollen joints, IgM-RF and the erosion score), closely approximated the maximal accuracy that could be achieved.

CONCLUSION

The outcome of RA can be predicted by a combination of variables that are commonly available in the clinical setting.

摘要

目的

确定类风湿关节炎(RA)的预后因素。

方法

对132例确诊为RA的女性患者从疾病早期(症状出现<5年)开始进行每年一次的随访,平均随访时间为6年。通过单预测因素分析和逻辑回归,将首次获得的临床和实验室变量以及功能能力评估的预后价值与几种结局指标(医生对疾病严重程度的评估、疾病活动度、放射学异常、功能能力和二线药物处方数量)相关联。

结果

对一种或多种结局指标预测性最强的变量为肿胀关节数、里奇评分、健康评估问卷评分、放射学异常、IgM类风湿因子(RF)阳性、IgG-RF阳性、HLA-DR4以及血清无半乳糖基IgG百分比升高。根据这些变量的几种组合计算出预测结局的准确性,在70%至80%之间。基于常见变量(肿胀关节数、IgM-RF和侵蚀评分)组合的准确性与所能达到的最大准确性非常接近。

结论

RA的结局可以通过临床环境中常见的变量组合来预测。

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