超敏C反应蛋白与类风湿关节炎疾病活动度相关性研究

A Correlation Study on Hypersensitive C-Reactive Protein and Disease Activity of Rheumatoid Arthritis

目的探讨超敏C反应蛋白(hs-CRP)与类风湿关节炎(RA)疾病活动度的相关性。方法选择RA患者216例作为观察组,同期健康体检者108例作为对照组。根据RA疾病活动评分(DSA28)=2.6为界将216例患者分为RA缓解期和RA活动期,处于疾病活动期的182例为疾病活动组,处于疾病缓解期的34例为疾病缓解组。分别记录压痛关节、肿胀关节数及部位,对关节痛的主观评价VAS评分,检测hs-CRP、C反应蛋白(CRP)、红细胞沉降率(ESR),观察hs-CRP、CRP与RA疾病活动评分DAS28的相关性。结果疾病活动组hs-CRP、CRP均显著高于疾病缓解组、正常组(P<0.05),疾病活动组DAS28显著高于疾病缓解组(P<0.05),疾病缓解组hs-CRP及CRP与正常组比较差异无统计学意义(P>0.05)。hs-CRP、CRP与RA疾病活动评分DAS28均存在显著的正相关关系(P<0.01)。以DAS28≥2.6、3.2、5.1为分界点绘制hc-CRP的ROC曲线,得出hc-CRP的最佳诊断界点分别为3.09、5.68、16.97 mg/L。结论 hc-CRP与RA疾病活动呈显著的正相关,可以为临床医生提供相对准确的参考。

Objective To investigate correlation between hypersensitive C-reactive protein（hs-CRP） and disease activity of rheumatoid arthritis（RA）.Methods A total of 216 RA patients were selected as observation group,and 108 healthy controls taking physical examination at the same period were selected as control group.The 216 patients were divided into RA activity period subgroup（n = 182） and remission period subgroup（n = 34） on the basis of RA disease activity score（DSA28） equal to 2.6.Numbers and locations of tenderness and swelling joints were recorded; VAS score for joint pain was subjectively evaluated; hs-CRP,CRP and erythrocyte sedimentation rate（ESR） were detected,and correlations among hs-CRP,CRP and RA disease activity DAS28 score were analyzed.Results The hs-CRP and CRP levels in RA active subgroup were significantly increased compared with those in RA remission subgroup and healthy group（P〈0.05）; DAS28 score in RA active subgroup was significantly higher than that in RA remission subgroup（P〈0.05）; there were no significant differences in hs-CRP and CRP levels between RA remission subgroup and control group（P〉0.05）.Correlation analysis of between hs-CRP and CRP with RA disease activity DAS28 score showed that there were significant positive correlations among them（P〈0.01）.The hc-CRP receiver operating characteristic（ROC）curve was respectively drawn on the train spacing points of DAS28 scores equal to or more than 2.6,3.2 and 5.1,and then the best diagnostic cut-off points of hc-CRP（3.09 mg / L,5.68 mg / L and 16.97 mg / L） were obtained.Conclusion Hs-CRP and RA disease activity showed significant positive correlation,and therefore it may provide a relatively accurate reference for clinicians.