在所有类风湿关节炎患者和数据库中,是否应该评估比胀或疼痛更常见的关节形?
Theodore Pincus1, Tengfei Li1, Kathryn A Gibson2
1Rush University Medical Center, Chicago, Illinois.
ACR open rheumatology
|May 20, 2025
概括
关节形计数 (DJC) 在类风湿性关节炎 (RA) 患者中很常见,即使胀和疼痛关节计数较低. 将DJC纳入常规护理和数据库对于准确的RA评估至关重要.
科学领域:
- 类风湿病学 类风湿病学
- 临床免疫学临床免疫学
- 整形外科 整形外科 整形外科
背景情况:
- 类风湿性关节炎 (RA) 管理依赖于评估关节炎症和损伤.
- 当代的RA护理侧重于疾病活动指数,通常基于胀关节计数 (SJC) 和柔软关节计数 (TJC).
- 关节形对日常护理中的疾病评估的影响不太清楚.
研究的目的:
- 分析类风湿性关节炎 (RA) 患者中胀关节数 (SJC),柔软关节数 (TJC) 和形关节数 (DJC) 的患病率和意义.
- 评估DJC与已建立的RA疾病活性指数相关.
- 确定DJC在常规RA护理中的临床实用性.
主要方法:
- 澳大利亚173名RA患者的横截面数据库的回顾性分析,疾病持续时间为10年.
- 对SJC,TJC和DJC的28项联合计数进行评估.
- 基于28个关节的疾病活动评分 (DA28),临床疾病活动指数 (CDAI) 和例行评估患者指数数据3 (RAPID3) 的DJC计算.
主要成果:
- 中位数的SJC为0,TJC为2.0,DJC为4.0. 这两者均为平均值.
- 虽然42%的患者的SJC+TJC为0或1,但只有38%的DJC为0或1.
- 符合SJC+TJC缓解标准的显著比例的患者 (47-58%) 仍然具有DJC≥2,表明持续的关节损伤.
结论:
- 形关节数 (DJC) 在类风湿性关节炎 (RA) 患者中很普遍,即使是那些基于SJC和TJC的临床缓解.
- 在大多数符合SJC+TJC缓解标准的患者中观察到DJC≥2.
- 应将DJC纳入长期常规护理和RA数据库,以进行全面的患者评估.
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