中华风湿病学杂志
中華風濕病學雜誌
중화풍습병학잡지
CHINESE JOURNAL OF RHEUMATOLOGY
2012年
9期
601-605
,共5页
关节炎,类风湿%评价研究%临床疾病活动指数%简化疾病活动指数
關節炎,類風濕%評價研究%臨床疾病活動指數%簡化疾病活動指數
관절염,류풍습%평개연구%림상질병활동지수%간화질병활동지수
Arthritis,rheumatoid%Evaluation studies%Clinical disease activity index%Simplified disease activity index
目的 评价临床疾病活动指数( CDAI)、简化疾病活动指数(SDAI)同疾病活动指数28( DAS28),对类风湿关节炎(RA)疾病活动性的评估价值.方法 连续纳入200例RA患者,评估每例RA患者的关节肿胀数(SJC)、关节压痛数(TJC)、患者对病情的总体评估(PGA)、医生对病情的总体评估( PhGA)、健康评估问卷(HAQ),检测红细胞沉降率(ESR)、C反应蛋白(CRP),计算DAS28、CDAI、SDAI.用Pearson相关分别分析DAS28、CDAI、SDAI与上述任意指标的相关性.按DAS28、CDAI、SDAI各活动分期截止点将200例RA患者分类,记录各活动期患者例数,用Kappa值描述CDAI与SDAI的内部一致性,并用Kappa值分别描述CDAI、SDAI与DAS28的内部一致性.以DAS28为参照标准,用ROC曲线描述CDAI和SDAI划分RA的缓解/低度和中/重度的区分效能.结果 200例RA患者的CDAI (17.2±11.1)、SDAI (19.1±11.6)与DAS28(4.3±1.5)均呈正相关(r=0.876,0.861,P＜0.05).二者及DAS28与HAQ(0.6±0.7)亦均呈正相关(r=0.522,0.523,0.482,P＜0.05).比较CDAI与SDAI,二者Kappa值为0.777,进一步比较CDAI、SDAI与DAS28的Kappa值分别为0.482,0.394.以DAS28作为参照标准,CDAI、SDAI的ROC曲线下面积分别为0.906、0.888.结论 CDAI、SDAI同目前国际公认的DAS28一样,亦可以很好地评估RA疾病活动性,且二者与HAQ的相关性高于DAS28.相比于SDAI,CDAI缺少炎性指标,但二者一致性极好,且CDAI与DAS28的内部一致性优于SDAI与DAS28.此外,CDAI划分RA的缓解/低度和中/重度的效能稍高于SDAI.CDAI更简便、快捷、准确,适用于RA的日常评估.
目的 評價臨床疾病活動指數( CDAI)、簡化疾病活動指數(SDAI)同疾病活動指數28( DAS28),對類風濕關節炎(RA)疾病活動性的評估價值.方法 連續納入200例RA患者,評估每例RA患者的關節腫脹數(SJC)、關節壓痛數(TJC)、患者對病情的總體評估(PGA)、醫生對病情的總體評估( PhGA)、健康評估問捲(HAQ),檢測紅細胞沉降率(ESR)、C反應蛋白(CRP),計算DAS28、CDAI、SDAI.用Pearson相關分彆分析DAS28、CDAI、SDAI與上述任意指標的相關性.按DAS28、CDAI、SDAI各活動分期截止點將200例RA患者分類,記錄各活動期患者例數,用Kappa值描述CDAI與SDAI的內部一緻性,併用Kappa值分彆描述CDAI、SDAI與DAS28的內部一緻性.以DAS28為參照標準,用ROC麯線描述CDAI和SDAI劃分RA的緩解/低度和中/重度的區分效能.結果 200例RA患者的CDAI (17.2±11.1)、SDAI (19.1±11.6)與DAS28(4.3±1.5)均呈正相關(r=0.876,0.861,P＜0.05).二者及DAS28與HAQ(0.6±0.7)亦均呈正相關(r=0.522,0.523,0.482,P＜0.05).比較CDAI與SDAI,二者Kappa值為0.777,進一步比較CDAI、SDAI與DAS28的Kappa值分彆為0.482,0.394.以DAS28作為參照標準,CDAI、SDAI的ROC麯線下麵積分彆為0.906、0.888.結論 CDAI、SDAI同目前國際公認的DAS28一樣,亦可以很好地評估RA疾病活動性,且二者與HAQ的相關性高于DAS28.相比于SDAI,CDAI缺少炎性指標,但二者一緻性極好,且CDAI與DAS28的內部一緻性優于SDAI與DAS28.此外,CDAI劃分RA的緩解/低度和中/重度的效能稍高于SDAI.CDAI更簡便、快捷、準確,適用于RA的日常評估.
목적 평개림상질병활동지수( CDAI)、간화질병활동지수(SDAI)동질병활동지수28( DAS28),대류풍습관절염(RA)질병활동성적평고개치.방법 련속납입200례RA환자,평고매례RA환자적관절종창수(SJC)、관절압통수(TJC)、환자대병정적총체평고(PGA)、의생대병정적총체평고( PhGA)、건강평고문권(HAQ),검측홍세포침강솔(ESR)、C반응단백(CRP),계산DAS28、CDAI、SDAI.용Pearson상관분별분석DAS28、CDAI、SDAI여상술임의지표적상관성.안DAS28、CDAI、SDAI각활동분기절지점장200례RA환자분류,기록각활동기환자례수,용Kappa치묘술CDAI여SDAI적내부일치성,병용Kappa치분별묘술CDAI、SDAI여DAS28적내부일치성.이DAS28위삼조표준,용ROC곡선묘술CDAI화SDAI화분RA적완해/저도화중/중도적구분효능.결과 200례RA환자적CDAI (17.2±11.1)、SDAI (19.1±11.6)여DAS28(4.3±1.5)균정정상관(r=0.876,0.861,P＜0.05).이자급DAS28여HAQ(0.6±0.7)역균정정상관(r=0.522,0.523,0.482,P＜0.05).비교CDAI여SDAI,이자Kappa치위0.777,진일보비교CDAI、SDAI여DAS28적Kappa치분별위0.482,0.394.이DAS28작위삼조표준,CDAI、SDAI적ROC곡선하면적분별위0.906、0.888.결론 CDAI、SDAI동목전국제공인적DAS28일양,역가이흔호지평고RA질병활동성,차이자여HAQ적상관성고우DAS28.상비우SDAI,CDAI결소염성지표,단이자일치성겁호,차CDAI여DAS28적내부일치성우우SDAI여DAS28.차외,CDAI화분RA적완해/저도화중/중도적효능초고우SDAI.CDAI경간편、쾌첩、준학,괄용우RA적일상평고.
Objective To compare the clinical disease activity index (CDAI) and simplified disease activity index (SDAI) as well as disease activity score 28 (DAS28) by assessing the activity of rheumatoid arthritis (RA) and to explore which one is better.Methods Two hundred RA patients were enrolled.Swelling joint counts (SJC),tenderness joint counts(TJC ),patient's and doctor's global assessment of disease activity based on visual analogue scale (PGA,PhGA),health assessment questionnaire (HAQ) were recorded and the erythrocyte sedimentation rate (ESR),C reaction protein (CRP) of each patient were tested.DAS28,CDAI,SDAI of all patients were calculated for all patients.Statistical analysis was carried out by Pearson correlation for the association between DAS28 and the above parameters,as well as CDAI,and SDAI.We created 4 patient groups based on DAS28,CDAI and SDAI ranks and used kappa statistics to assess the level of overall agreement of different disease activity categories between any of the two indices above for individual patients.We assessed the discriminating validity using receiver operating characteristic (ROC) curve analysis to compare the ability of the CDAI and SDAI to discriminate betwecn patients with remission, low and moderate,high disease activity.Results Of all the patients,CDAI(17.2±11.1) and SDA[(19.1±11.6) were correlated with DAS28 (4.3±1.5),the correlation coefficients were 0.876,0.861 (P＜0.05) respectively.CDAI and SDAI were correlated with HAQ (0.6±0.7),as well as DAS28.The correlation coefficients were 0.522,0.523,and 0.482 (P＜0.05).The Kappa of CDAI and SDAI was 0.777.The Kappa of CDAI and DAS28,SDAI and DAS28 were 0.482,0.394.The areas under ROC of CDAI and SDAI were 0.906,0.888 if DAS28 was used as the gold standard.Conclusion CDAI and SDAI as well as DAS28 can be used to assess the activity of RA and both are better correlated with HAQ than DAS28.Though there is no CRP in CDAI when compared with SDAI,CDAI has very good overall agreement with SDAI and the overall agreement of CDAI and DAS28 is better than SDAI and DAS28.In addition, CDAI is better in discriminating between patients with remission/low and moderate/high disease activity.So,CDAI is a simple,convenient,accurate,quick assessment tool and is suitable for daily application.
